We interpreted Burbank, CA as Burbank, CA. Other options include: Burbank (Santa Clara County), CA
- 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
- 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 ... needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and...for Hiring. **Req ID** : 12949 **Working Title** : Registered Nurse - ISP Care Coordinator -… 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/236088/ 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
- 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
- Elevance Health (Los Angeles, CA)
- RN Medical Management Nurse - California...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or ... 6pm PST. Rotating Weekends and holidays. The **Medical Management Nurse ** is responsible for review of the...Med/Surg, Critical Care, ER, Telemetry, etc. strongly preferred. + Utilization management/ review within managed care or hospital… more
- University of Southern California (Glendale, CA)
- …PRO regulations, JCAHO standards and contractual agreements with insurers or outside review agencies. Minimum Education: Current RN license in the State ... of California, BSN preferred Minimum Experience/Knowledge: Recent experience in Utilization /Quality/Case Management in acute setting preferred Required License/Certification: Current… 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)
- …(Sat & Sun 8am-12pm CST, with a comp day during the week) The ** Nurse Reviewer I** is responsible for conducting preauthorization, out of network and appropriateness ... on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with… 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...is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more
- University of Southern California (Arcadia, CA)
- …requirements impact DRG assignments. + Minimum of three years' experience in clinical disciplines ( RN , MD, FMG) or utilization review /case management in an ... and other clinical staff. + Meets established productivity targets for record review and appropriate query placement. + Demonstrates working knowledge of ICD-10 CM… more
- Elevance Health (Los Angeles, CA)
- **Telephonic Nurse Case Manager II** **Sign on Bonus: $5000.** **Location: This role enables associates to work virtually full-time, with the exception of required ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more