- The County of Los Angeles (Los Angeles, CA)
- …OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator , CCS.** -OR- OPTION II: Two (2) ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...In the County of Los Angeles, a Medical Service Coordinator , CCS (https://www.governmentjobs.com/careers/lacounty/classspecs/1065117) determines medical eligibility of children referred… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one… 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
- Dignity Health (Long Beach, 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 ... 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 for… more
- Dignity Health (Long Beach, 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… 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 ... innovation. **A Little More About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient while hospitalized and upon… more
- Cedars-Sinai (Beverly Hills, CA)
- …Medical Center is seeking a highly motivated and experienced Supply Chain Pharmacy Coordinator to join our team in Los Angeles, CA. Under the direction of ... a Pharmacy Manager, the Coordinator will play a critical role in developing, implementing, and monitoring pharmacy programs, leading pharmacy practice advancement,… more
- Carnival Cruise Line (Santa Clarita, CA)
- …Love Boat promises something for everyone. We are seeking an exceptional Coordinator , Disbursements to fill this remote-based role in Santa Clarita. This position ... processing, bank research, ad-hoc reporting, follow-up with bank personnel, and utilization of resources (people & systems) within corporate values, policies, and… more
- UCLA Health (Los Angeles, CA)
- …external, to assist patients with discharge/post hospital care + Interact closely with Utilization Review and Patient Business Services to ensure correct and ... Description In this role as a Transplant Financial Coordinator you will: + Perform all admission functions...in the functional operations of third party payors and utilization review agencies to expeditiously coordinate follow-up… more
- Dignity Health (Los Angeles, CA)
- …and community. + Attends LA County DMH meetings and trainings pertaining to utilization review , billing and audit procedures, data entry, and reimbursement. + ... **Job Summary and Responsibilities** As our Quality Coordinator , you will be a pivotal driver of...meetings with clinical staff. + Conducts internal audit and utilization review activities on cases and informs… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …teams, referral staff, and scheduling coordinators to confirm registration readiness, review appointment utilization , and escalate capacity-related issues. A ... That Matters.** **Overview** **Schedule:** Day Shift **Purpose Statement/Position Summary:** The Coordinator Ambulatory Access plays a key role in supporting patient… more
- UCLA Health (Los Angeles, CA)
- …Health ICM Coordinator plays a key role in supporting our Utilization Management team to ensure safe, high-quality, and cost-effective care for patients enrolled ... outreach to support continuity of care and prevent avoidable hospitalizations. + Review and track claims, authorizations, and compliance with CMS regulations. +… more
- University of Southern California (Arcadia, CA)
- …outside referring physicians andmedical groups.* Communicates with insurance company utilization review and authorization personnel.* Gathers and maintains ... physician in complex cases with multiple practitioners.* Ensures appropriate resource utilization relevant to the financial, regulatory and clinical aspects of… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION: ... the work of staff, and evaluating employee performance. For this examination, Utilization Review is defined as provides technical and administrative direction… more
- The County of Los Angeles (Los Angeles, CA)
- …and track the number of departmental contracts requiring the Board of Supervisor's review and approval. + Oversees the review and tracking of department-wide ... databases, status reports, and projected timelines for submission to executive staff for review . + Develops new or modified policies and procedures for completion of… more
- The County of Los Angeles (Los Angeles, CA)
- …prevention services including but not limited to forecasting utilization and cost, cost/finance analyses, cost-effectiveness analyses, and predictive/prescriptive ... revenue, and to reduce the cost of unnecessary waste and over/under utilization of services. + Conducts predictive data assignments for Behavioral Health Quality… more
- University of Southern California (Arcadia, CA)
- POSITION SUMMARY The purpose of the Case Coordinator position is to support the physician and interdisciplinary team in the provision of patient care, with the ... timely and accurate information to payers. The role integrates and coordinates utilization management, care facilitation, and discharge planning functions. The Case … more
- The County of Los Angeles (Los Angeles, CA)
- …NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care, Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug Information, ... NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care, Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug Information,… more
- University of Southern California (Los Angeles, CA)
- …+ Req 5 years Clinical experience + Req 2 years Ambulatory case management or utilization review experience within the last three years + Req Ability to work ... The role integrates the functions of complex case management, utilization management, quality management, discharge planning assessment, and coordination of… more
- The County of Los Angeles (Los Angeles, CA)
- …solicitations and contracts are developed pursuant to best practices. Review contracting opportunities with applicability to Community-Based Organizations (CBOs), ... and advertisements are provided and facilitate opportunities for competition. Review Department solicitation practices to provide strategic recommendations and… more