- Sharp HealthCare (San Diego, CA)
- …of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager ( UM ) partners with the Centralized Patient Placement ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case… more
- LA Care Health Plan (Los Angeles, CA)
- …required to achieve that purpose. Job Summary The Utilization Management ( UM ) Admissions Liaison RN II is primarily responsible for receiving/reviewing ... Utilization Management Admissions Liaison RN II ...vs. observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II ...and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve… more
- LA Care Health Plan (Los Angeles, CA)
- …member care with internal LA Care departments such as Care Management (CM), Utilization Management ( UM ), Managed Long Term Services and Support (MLTSS), Social ... and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required… more
- Sharp HealthCare (San Diego, CA)
- …within two months of discharge.Follows policies and procedures for all Utilization Management ( UM ), discharges, Standardized Outcome Measures, Durable Medical ... to the PT Supervisor or supporting clinical specialist (PT II or PT III) for resolution in a timely...and patient status reports.Anticipates and completes documentation needs (ie UM , POCs, patient status reports) prior to their due… more