- 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
- Providence (Mission Hills, CA)
- **Description** RN - Utilization Review ...+ Associate's Degree in Nursing. + Upon hire: California Registered Nurse License + 2 years of ... Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse… 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
- 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. ... documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established… 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
- Select Medical (Los Angeles, CA)
- …Cedars, UCLA and Select Medical Century City / Los Angeles, CA Case Manager (CM) - Registered Nurse ( RN ) or Social Worker (LCSW) **Per Diem** **Pay Rate: ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… 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
- 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
- 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
- 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 ... **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 (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 ... 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
- Select Medical (Los Angeles, CA)
- …/ Los Angeles, CA Case Manager (CM) - Full Time (on-site) - 8 hr shifts Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW) **Schedule: Mon - ... + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal… more
- Cedars-Sinai (Beverly Hills, CA)
- …Heart Association or American Red Cross required. + Certified Case Manager (CCM) for Registered Nurse preferred. **Experience:** + Two (2) years of Managed Care ... Little More About What You Will be Doing** The RN Supervisor Case Management will assist in the daily...nursing, discharge planning and HMO, previous case management experience, utilization review , and knowledge of medical/nursing standards… more
- HCA Healthcare (Thousand Oaks, CA)
- …in your career path, we encourage you to apply for our Registered Nurse OR First Assist opening. We review all applications. Qualified candidates will be ... below midpoint of the range. **Introduction** Do you have the career opportunities as a(an) Registered Nurse OR First Assist you want in your current role? We… 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
- Cedars-Sinai (Marina Del Rey, CA)
- …us one of America's Best Hospitals! **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates care of the patient from ... the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for… more