- Providence (Torrance, CA)
- **Description** ** Appeals RN - Care Manager...Degree Nursing. + Upon hire: California Registered Nurse License. + 2 years Direct patient care ... Per Diem and will work 8-hour, Day shifts.** The Care Management Recovery Advocate (CMRA) is responsible...management certification. + Experience working with denials and appeals in/for an acute care setting. +… more
- University of Southern California (Arcadia, CA)
- …and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The Case ... of pre-certification and payer authorization processes, facilitation of the collaborative management of patient care across the continuum, intervening as… more
- Molina Healthcare (Long Beach, CA)
- …skills. * Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** * Registered Nurse ( RN ). License must be active and ... JOB DESCRIPTION **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement...to overarching strategy to provide quality and cost-effective member care . We are looking for LVN's with at least… more
- Elevance Health (Costa Mesa, CA)
- …resources. + Applies clinical knowledge to work with facilities and providers for care -coordination. + May also manage appeals for services denied. + Serves ... **Manager II Medical Management ** **Location:** This role requires associates to be...policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, programs… more