- Providence (Mission Hills, CA)
- **Description** ** RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part - time and will work 8-hour, ... must empower them. **Required Qualifications:** + Associate's Degree - Nursing. + California Registered Nurse License upon hire. + 2 years - Experience working… more
- Fresenius Medical Center (Bellflower, CA)
- …while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans ... looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Cedars-Sinai (Los Angeles, CA)
- …care field preferred Foreign trained MDs will be considered License/Certifications: Registered Nurse , LVN, Occupational Therapist, Physical Therapist, Physician ... of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required...for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist -… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228577/ rn -case-manager utilization - ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April… more
- The County of Los Angeles (Los Angeles, CA)
- …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN … more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... affects lives. When you join Emanate Health, you become part of a team that works together to strengthen...protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices.… more
- Prime Healthcare (San Dimas, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference....to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- Elevance Health (Los Angeles, CA)
- RN Utilization Management Nurse (NICU...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any ... 6pm PST. Rotating Weekends and holidays. The **Medical Management Nurse ** is responsible for review of the...clinical experience in NICU / Peds strongly preferred. + Utilization management/ review within managed care or hospital… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... that fuels innovation. **A Little More About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient while hospitalized… more
- LA Care Health Plan (Los Angeles, CA)
- …Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN );current and unrestricted California ... by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health… more
- Cedars-Sinai (Los Angeles, CA)
- …approved by the California Board of Registered + Current State of California Registered Nurse and Nurse Practitioner License + National Certification as ... find opportunities to enhance clinical efficiency and appropriateness of care. As part of a multi-disciplinary team, develops and implements interventions to achieve… more
- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... most prone to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions + Administers, either… more
- Elevance Health (Los Angeles, CA)
- …and outpatient professional treatment health benefits through telephonic or written review . **Location:** Virtual: This role enables associates to work virtually ... with an emphasis on Outpatient Providers. + Performs timely Behavioral Health utilization reviews. + Work with multidisciplinary teams to facilitate continuity of… more
- Elevance Health (Los Angeles, CA)
- …facility-based and outpatient professional treatment health benefits through telephonic or written review . **Primary duties may include but are not limited to:** + ... equivalent background. + Current active unrestricted license, such as RN LCSW LMSW LMHC LPC LBA (as allowed by...adapt to new technologies preferred. + Previous experience in utilization management with a broad range of experience with… more
- Elevance Health (Los Angeles, CA)
- **Telephonic Nurse Case Manager II** **Sign on Bonus: $2000.** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more