- Elevance Health (Woodland Hills, CA)
- **Clinical Operations Medical Director** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management ** **$20,000 Sign On Bonus** ... members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Prime Healthcare (Lynwood, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/163839/rn-case-manager utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to… more
- Providence (Anaheim, CA)
- …+ Bachelor's Degree in Healthcare related field. + 3 years' Experience in utilization management or case management . **Why Join Providence?** Our ... **Description** Care Management is a collaborative practice model including the...2 years' related work experience. + California Licensed Vocational Nurse upon hire + 2 years' Clinical experience in… more
- Prime Healthcare (Ontario, CA)
- … Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according to ... A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management ...a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA) certificate upon hire… more
- Dignity Health (Northridge, CA)
- …setting required. + Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or insurance setting required. + ... 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing… more
- Emanate Health (Covina, CA)
- …of California, and hospital policies, goals, and objectives. Completes Utilization Review of Behavioral Health Services. Charge Nurse will have expert ... care providers. Provides patient care as needed. The Charge Nurse is responsible for the internal management of the nursing unit functions and staff, along with… more
- Universal Health Services (Chino, CA)
- …way possible given their specific needs. Responsible for providing quality case management , utilization review activities and psychotherapeutic services to ... Qualifications + Minimum Bachelor's degree in Social Work.or Registered Nurse with current California license + 2 years of...preferred; + Written and oral communication skills, knowledge of utilization management & skills in case … more
- Cedars-Sinai (Tarzana, CA)
- …assigned unit. + Responsible for administrative support activities involving facilities management , pharmacy, utilization management , quality management ... Supervisor is expected to manage the overall unit, is for budget management , scheduling, payroll, overall safety of the unit, policies/procedures are accurate and… more
- Fresenius Medical Center (Irwindale, CA)
- …barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and Standing Orders, ... quality improvement tools and electronic applications. + Performs desk review of facility Quality Assessment and Performance Improvement (QAPI) documentation… more
- Dignity Health (Glendale, CA)
- …high levels of patient satisfaction. The RN Care Coordinator consistently conducts the utilization review process and the discharge planning process as required ... experience in an acute hospital setting. One year case management in an acute care hospital preferred. + Prior...required experience may be considered. **Education:** + Current Registered Nurse (RN) license. + BSN degree or experience equivalent… more