- 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 ...Los Angeles, a Utilization Review Nurse is an RN that has Case… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… 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 ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Dignity Health (Glendale, CA)
- …the individual to competently perform the job. + Five (5) years experience in utilization review and discharge planning, case management and managed care. Other ... capitated to the Dignity Health hospitals (as well as participation in In-Network Utilization management). in the GSSJSA and to provide support to the Director,… more
- Prime Healthcare (Lynwood, CA)
- …Shift Days Connect With Us! (https://careers-primehealthcare.icims.com/jobs/209331/case-manager%2c- rn utilization - review ... 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
- Molina Healthcare (Los Angeles, CA)
- **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_3-12 NIGHT SHIFT: 7:30PM - 08:30AM PACIFIC HOURS NON EXEMPT, 3 days a week will rotate._** **_TRAINING SCHEDULE ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Inpatient/ Concurrent Review , Utilization Review / Utilization Management and… more
- Molina Healthcare (Los Angeles, CA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- Molina Healthcare (Los Angeles, CA)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … 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
- LA Care Health Plan (Los Angeles, CA)
- …Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and ... Managed Long Term Services and Supports Nurse Specialist RN II Job Category:...home care, palliative care, hospice care OR experience in Utilization Review or Care Management will be… more
- The County of Los Angeles (Los Angeles, CA)
- …clinical nursing. LICENSE(S) AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board or Registered ... in a state other than California must provide their Registered Nurse License Number from that state...Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …satisfaction throughout the continuum of care. Responsibilities The Referral Coordination Team (RCT) Registered Nurse ( RN ) is responsible for executing a ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Dignity Health (Glendale, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the...will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... 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
- UCLA Health (Los Angeles, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in...and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three… more
- Guidehouse (Los Angeles, CA)
- …Required** **:** None **What You Will Do** **:** The **Hospital Admitting Registered Nurse PART** **TIME, varied shiftts** will facilitate patient medical ... of prior relevant experience, 2 of the years as RN + Graduation from an accredited school of nursing....Nice To Have** **:** + Two years' experience in utilization review with external payors within a… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Nurse Specialist RN...inpatient setting. Performs telephonic and/or onsite admission and concurrent review , and collaborates with onsite staff, physicians, providers, member/family… more
- Emanate Health (Covina, CA)
- …of California, and hospital policies, goals, and objectives. Completes Utilization Review of Behavioral Health Services. Charge Nurse will have expert ... States, and the #19 ranked company in the country. **Job Summary** The Charge Nurse is responsible for supervising staff and the operation and overall flow of the… more
- Molina Healthcare (Los Angeles, CA)
- …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in nursing. ... **JOB DESCRIPTION** **Job Summary** The **Delegation Oversight Nurse ** is responsible for ensuring that Molina Healthcare's... (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit… more
- Molina Healthcare (Los Angeles, CA)
- …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in Nursing. ... Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable state… more