- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and… more
- Robert Half Office Team (Los Angeles, CA)
- …* Facilitate, coordinate and approve medical referrals that meet specific criteria as a Utilization Management Nurse Specialist RN * Ensure timely ... Description We are seeking a UM Review Nurse to ensure the quality and cost-efficiency of...Function as a department guide for medical service requests/referral management and procedures * Handle incoming calls from providers,… more
- United Therapeutics (CA)
- …and pulmonary diseases, and other orphan diseases. **How you'll contribute** The Regional Nurse Specialist (RNS) is an educational resource deployed to help ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …work experience License/Certification: CA Registered Nurse (RN), CNS - Clinical Nurse Specialist certified by the California Board of Registered Nursing. ... summarizes the general nature, level and purpose of the job. Clinical Nurse Specialists are Master's Degree prepared advanced practice Registered Nurses in roles… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Resource Management issues, other issues including concerns involving under/over utilization , avoidable days and quality issues. 13. Responsible for all incoming… more
- LA Care Health Plan (Los Angeles, CA)
- …the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and ... Enhanced Care Management Clinical Specialist II Job Category:... Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer:… more
- Alameda Health System (San Leandro, CA)
- SLH Care Management Specialist + San Leandro, CA + San...years in a health care field or one year in Utilization Management at a Medical Group or Health ... in-patient and post discharge services. 5. Per the direction of the Care Management social worker and/or nurse , facilitates, identifies and documents all… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... support the safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential… more
- The Arora Group (Twentynine Palms, CA)
- …(WII) under the Psychological Health Transition to Care Initiative in the Case Management / Utilization Management Division at Naval Hospital 29 Palms . ... process, including assessment, planning, implementation, coordination, and monitoring. + Integrate case management (CM) with utilization management (UM) and… more
- Highland General Hospital (San Leandro, CA)
- …Required Experience: Three years in a health care field or one year in Utilization Management at a Medical Group or Health plan experience; electronic Health ... in-patient and post discharge services. 5. Per the direction of the Care Management social worker and/or nurse , facilitates, identifies and documents all… more
- Sharp HealthCare (La Mesa, CA)
- …Nursing; California Registered Nurse (RN) - CA Board of Registered Nursing; Clinical Nurse Specialist (CNS) - CA Board of Registered Nursing; AHA Basic Life ... business practices. **What You Will Do** Masters or doctoral prepared with Clinical Nurse Specialist Certificate who plans, directs and executes all Magnet… more
- Sharp HealthCare (Chula Vista, CA)
- …Association for Healthcare Quality; Certified Professional in Healthcare Risk Management (CPHRM) - American Hospital Association; Certified Professional in Patient ... (CPPS) - Certification Board for Professionals in Patient Safety; California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree in Nursing… more
- Stanford Health Care (Palo Alto, CA)
- …professional growth and development of their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified ... (1) year of experience as a licensed advanced practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered … more
- The Arora Group (Coronado, CA)
- …algorithms, CM software, and databases for community resources. + Integrate CM and utilization management (UM) and integrating nursing case management with ... Certification of Disability Management Specialists Commission: Certified Disability Management Specialist (CDMS) + Association of Rehabilitation Nurses:… more
- Dignity Health (San Bernardino, CA)
- …for more information. **Responsibilities** The Clinical Document Specialist - Case Manager is responsible for managing ... other Federal or State regulatory agency requirements specific to Utilization Review and Discharge Planning. The Case Manager partners...degree in Nursing (MSN) with a concentration in Case Management can serve as a substitute for the experience… more
- Edwards Lifesciences (Riverside, CA)
- …difference to patients around the world. As a part of the Field Clinical Specialist team, you will be a critical part of delivering our patient focused innovations, ... Quality, Regulatory, and Education. After extensive training, a Field Clinical Specialist will travel frequently within an assigned territory, clinically training… more
- Sharp HealthCare (San Diego, CA)
- …position, and employer business practices. **What You Will Do** To provide comprehensive utilization management and coordination of care for members who are ... **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing &...plan requirements for documentation of concurrent SNF review and utilization management activities performed in a manner… more
- Universal Health Services (Palmdale, CA)
- …. Job Summary: The Southwest Healthcare is seeking a Registered Nurse Clinical Documentation Improvement Specialist for our Palmdale, CA ... concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. Duties include but not limited… more
- Sharp HealthCare (San Diego, CA)
- …skills in area of expertise. + Proficient knowledge and understanding of utilization management , transition planning, alternative options, goals and outcomes, ... Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse (RN) - CA Board of… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE II - NORTH COUNTY Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1164632) Apply REGISTERED NURSE II - NORTH COUNTY ... + Serves as a liaison between committees, staff, and management . + Participates in identifying and resolving ethical issues...practice setting. + Serves as a preceptor: expert or specialist who gives practical experience and training to new… more