- Elevance Health (Los Angeles, CA)
- RN - Utilization / Medical Management Nurse / InPatient (JR171072) **Work Hours** : 8 hour shift within 8am - 6pm PST. Rotating Weekends and holidays. ... 8am - 6pm PST. Rotating Weekends and holidays. The ** Medical Management Nurse ** is responsible...an equivalent background. + Current active, valid and **unrestricted RN license** to practice as a health professional within… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management ( UM ) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical… more
- Cedars-Sinai (Beverly Hills, CA)
- …Los Angeles Fair Chance Initiative for Hiring. **Req ID** : 12509 **Working Title** : Registered Nurse - Care Coordinator - 8 Hour Days **Department** : Case ... Science degree in Nursing required **License/Certifications:** + Valid CA RN license required + Certified Case Management ... Surgical/Tele/ICU) with 2 or more year of care management experience ( UM or DC Planning). +… more
- LA Care Health Plan (Los Angeles, CA)
- …for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted California ... required to achieve that purpose. Job Summary The Utilization Management ( UM ) Admissions Liaison RN ...Works with UM leadership, including the Utilization Management Medical Director, on requests where determination… more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- Molina Healthcare (Los Angeles, CA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications** * At least… more
- Cedars-Sinai (Beverly Hills, CA)
- …be Doing** The RN Care Coordinator is responsible for the case management of patient while hospitalized and upon discharge from various care settings. In ... (Access Express) no later than date of discharge. + Communicates with CSMPN Medical Director, Employee Health Services, Risk Management , and TPA + Attends… more
- Dignity Health (Los Angeles, CA)
- …(5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification preferred + Knowledge of managed care and ... a sign-on bonus not to exceed 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning… more
- LA Care Health Plan (Los Angeles, CA)
- …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... ECM and receives clinical supervision as needed from the Medical Director of Care Management . The position...care with internal LA Care departments such as Care Management (CM), Utilization Management ( UM ),… more
- UCLA Health (Los Angeles, CA)
- …- $341,800/annually Qualifications We're seeking an experienced leader with: + A Registered Nurse License, Advanced Practice Provider ( Nurse Practitioner ... programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group (FPG) Management Services Organization… more
- Elevance Health (Los Angeles, CA)
- …necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Ability to work with all levels ... equivalent background. + Current active unrestricted license such as RN LCSW LPC (as allowed by applicable state laws)...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis… more