- LA Care Health Plan (Los Angeles, CA)
- …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer: The expected pay… more
- Centene Corporation (Sacramento, CA)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... align to goals and objectives + Develops, implements, and maintains compliance with utilization management policies and procedures + Reviews utilization… more
- Fresenius Medical Center (Garden Grove, CA)
- …and post procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... **POSITION FEATURES:** This is a full time RN role for our surgery center in Garden...values and customer service philosophy. Adheres to the FVC/FMCNA Compliance Program, including following all regulatory and FVC/FMS policy… more
- Fresenius Medical Center (Santa Paula, CA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... PHYSICIANS: + Facilitates the application process for physician privileges and compliance with Fresenius Medical Care Medical Staff By-Laws. + Responsible for… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE II - NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1164632) Apply REGISTERED NURSE II - NORTH ... 1. Three years of full-time experience* at the level of Los Angeles County classification Registered Nurse I**. -AND- 2. A license to practice as a Registered… more
- Sutter Health (Roseville, CA)
- …+ Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + ... acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the… more
- Sutter Health (Burlingame, CA)
- …: **EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California Upon Hire CCM certification ... acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking full-time ** Registered Nurse ( RN ) Health Educators** supporting **Naval Medical Center San Diego, CA ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Amergis (Oakland, CA)
- …coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical ... for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in...of services + Follows State/County mandated guidelines for the nurse case management programs + Participates in… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN (Outpatient) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN... compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, ... support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN ... compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve medically… more
- MTC (Calexico, CA)
- …the use of appropriate sanitation methods. 6. Practice basic cost containment and utilization management for patient care and facility operations. 7. Maintain ... regimens under the direction of a licensed physician or mid-level provider in compliance with MTC Medical and Ohio Department of Rehabilitation and Correction (ODRC)… more
- Dignity Health (Rancho Cordova, CA)
- …skills. - Graduate of an accredited school of nursing. - Clear and current CA Registered Nurse ( RN ) license. **Preferred Qualifications:** - 7 years UM ... the guidance and supervision of the department Manager/Director, the Supervisor of Utilization Management is responsible and accountable for coordination of… more
- Dignity Health (Rancho Cordova, CA)
- …This position will involve rotating Saturday coverage.** **Position Summary:** The Manager of Utilization Management (UM) is responsible for managing the day to ... day operation of Utilization Management Department and Prior Authorization (PA)...in Healthcare related field. - Clear and current CA RN license - Strong supervisory and management … more
- Universal Health Services (Temecula, CA)
- … Utilization Review Nurses who will be responsible for carrying out utilization management functions by planning, coordinating, and managing patient needs ... correct payer source for hospitalization and communication. + Ensures compliance of utilization review practices as required...Other Skills and Abilities: + Demonstrates knowledge and ensures compliance with the Nurse Practice Act, The… more
- Sharp HealthCare (San Diego, CA)
- …Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse ( RN ) - CA Board of Registered ... care and supports other members of the System Centralized Utilization Management team to ensure final status...clinical experience as defined by the CBA + California Registered Nurse ( RN ) - CA… more
- Sharp HealthCare (San Diego, CA)
- …Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Actalent (Ontario, CA)
- …requirements. This position complies with the scope of services defined by the Registered Nurse RN state licensure requirements. This position integrates ... care coordination for patients under the direction of a Registered Nurse and in compliance ...for case management scope of services including: Utilization Management supporting medical necessity and denial… more
- Actalent (San Diego, CA)
- …admission status and patient classification. Skills: case management , acute care, registered nurse , utilization management , Care management ... complies with the scope of services defined by the Registered Nurse RN state licensure...for case management scope of services including: Utilization Management supporting medical necessity and denial… more