- Sutter Health (Alameda, CA)
- …and assists in meeting financial targets by effectively managing utilization , productivity, personnel and supplies. Participates as necessary in referral ... Description:EDUCATION:Graduate of an accredited school of nursing.CERTIFICATION & LICENSURE:RN-Registered Nurse of CaliforniaBLS-Basic Life Support Healthcare ProviderTYPICAL EXPERIENCE:1 Year… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Prime Healthcare (Ontario, CA)
- …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/158530/ utilization - review -training- supervisor ... or online training in support of corporate revenue cycle initiatives to streamline utilization review (UR) and the denial management (DM) processes. This… more
- Dignity Health (Rancho Cordova, CA)
- …Summary:** Under the guidance and supervision of the department Manager/Director, the Supervisor of Utilization Management is responsible and accountable for ... Ensures UM Physicians are provided the relevant information needed to accurately review a referral. Fosters the relationship between the Pre-Authorization team and… more
- Sharp HealthCare (San Diego, CA)
- …Day **FTE** 1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** ... and authorizes medical services that meet medical criteria. The review of care is region specific and consists of...hospital, SNF, medical clinic etc.) + California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing &… more
- Sharp HealthCare (San Diego, CA)
- …Day **FTE** 1 **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing & Psychiatric Technicians **Hours** ... and authorizes medical services that meet medical criteria. The review of care is region specific and consists of...hospital, SNF, medical clinic, etc). + California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing &… more
- Ventura County (Ventura, CA)
- …and patient care as indicated and required; + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments; and + ... Registered Nurse I/II and Nurse Extern -...Services + Public Health + Telemetry + Trauma + Utilization Review (UR) + None/Other 05 Please… more
- ERP International (San Diego, CA)
- …that of other individuals performing similar services. Participate in peer review and performance improvement activities. Practice aseptic techniques as necessary. ... events. Anticipate potential problems/emergencies and make appropriate interventions. Notify supervisor , leadership, or other designated person regarding problems that… more
- Fresenius Medical Center (San Diego, CA)
- …and collaborates with supervisor and Education Department regarding progress of new nurse + Continues to mentor and support new nurses once released to work ... and work hours. **PURPOSE AND SCOPE:** The professional registered nurse Home Therapies RN CAP 2 may be an...Performs all essential functions under the direction of the Supervisor and with guidance from the Educator, Preceptor or… more
- Fresenius Medical Center (Mission Viejo, CA)
- …or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse , Supervisor or Physician as needed. + Assesses, collaborates, and ... and collaborates with supervisor and Education Department regarding progress of new nurse + Continues to mentor and support new nurses once released to work… more
- Fresenius Medical Center (South San Francisco, CA)
- …or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse , Supervisor or Physician as needed. + Assesses, collaborates, and ... and collaborates with supervisor and Education Department regarding progress of new nurse + Continues to mentor and support new nurses once released to work… 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 ... that of other individuals performing similar services. Participate in peer review and performance improvement activities. Practice aseptic techniques as necessary.… more
- Cedars-Sinai (Santa Monica, CA)
- …as well as patient care assessments, and a variety of medically related tasks. The Supervisor is a licensed nurse who works in an administrative role in an ... named us one of America's Best Hospitals. **Why Work Here?** The Clinical Supervisor , Operations supports the physician and clinical staff in the delivery of health… more
- Cedars-Sinai (Tarzana, CA)
- …as well as patient care assessments, and a variety of medically related tasks. The Supervisor is a registered nurse who works in an administrative role in an ... **Job Description** The Supervisor of Clinical Operations RN supports the physician...certifications and licensing requirements. + Assists in the development, review , and revision of standard operating policies and procedures… more
- Marriott (Sacramento, CA)
- …workers' compensation losses. The NCM is responsible for conducting first level Utilization Review and coordinates subsequent levels if necessary, as required ... **Additional Information** Nurse CARE Manager (CARE - Coordinated Action and...that may include multiple states. + Conducts first level utilization review per jurisdictional requirements. + Coordinates… more
- John George Psychiatric Pavilion (San Leandro, CA)
- … utilization and an appropriate level of care. 5. Coordinates all utilization review functions, including response to payor requests for concurrent and ... Initiates the appeal process, at the direction of the Supervisor and/or physician advisors, until the case is overturned,...of Case Management experience in an acute setting or utilization review at a medical group or… more
- LA Care Health Plan (Los Angeles, CA)
- …Auditor RN II is responsible for ensuring that delegates contracted to perform Utilization Management (UM) functions on behalf of LA Care (LAC) is in compliance ... Care Health Plan regarding UM issues. The position assists in improving access and utilization performance of Plan Partners and PPGs by being a resource for best… more
- Sharp HealthCare (San Diego, CA)
- …with the Sharp Extended Care (SEC) provider on site and/or telephonically. Keeps SEC Nurse Supervisor or SEC provider of any adverse development, delay in ... Complies with contracted health plan requirements for documentation of concurrent SNF review and utilization management activities performed in a manner… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Requirements Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), … more
- Sharp HealthCare (La Mesa, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... Healthcare Professional (AHA BLS Healthcare) - American Heart Association; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **Shift Start… more
