, Commercial, etc.) 2+ years of utilization management experience Strong knowledge of utilization management processes... clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special...
management experience Strong knowledge of utilization management processes and industry best practice In-depth knowledge... clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special...
. Required Qualifications Current, unrestricted Registered Nurse (RN) license in California. 3–5 years of utilization management.... We are in search of a highly motivated candidate to join our talented Team. Job Title: Utilization Management Technician Location...
Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years acute care nursing experience...! Responsibilities: Responsible for the quality and resource management of all patients that are admitted to the facility from the...
Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years acute care nursing...Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...
Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC... Behavioral Health Utilization Management Clinician, Senior, will report to the Manager of Behavioral Health Utilization...
: Care Management / Utilization Management Salary: $80,000–$95,000 (based on licensure and experience) Position Summary... scope of practice. Collaborate closely with Utilization Management, Case Management, and interdisciplinary teams to ensure...
on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support. May... Certification in Utilization Review, Care Management, or Clinical Nursing preferred. Additional requirements for specific...
. Valid Basic Life Support (BLS) CPR Certification Valid California Licensed Vocational Nurse (LVN) or Registered Nurse (RN...VISTA UNIFIED SCHOOL DISTRICT LICENSED VOCATIONAL NURSE (LVN) Purpose Statement The purpose of a Licensed...
communities and residents and to support the safety net required to achieve that purpose. Job Summary The Care Management... Specialist II utilizes clinical skills and training to perform essential functions of care management for identified and assigned...
in utilization review, case management, coding, or clinical auditing: Preferred Licenses/Certifications: Current licensed RN..., documentation gaps, and payer requirements for authorization and coverage. Collaborates with Case Management, Utilization Management...
in Nursing or Social Work. Registered Nurse (RN) license preferred. Licensed (LVN or LPN) nurse acceptable. Two (2) year clinical..., current and discharging residents needs in area(s) of responsibility. Complete documentation as required. Performs utilization...
in Nursing or Social Work. Registered Nurse (RN) license preferred. Licensed (LVN or LPN) nurse acceptable. Two (2) year clinical..., current and discharging residents needs in area(s) of responsibility. Complete documentation as required. Performs utilization...
and/or ManagedCare., upon hire and Registered Nurse: CA, upon hire Preferred Bachelors Of Nursing and Utilization Management...Where You’ll Work: Bakersfield Memorial Hospital includes 385 general acute beds, 48 licensed critical care beds, 13...
and/or ManagedCare., upon hire and Registered Nurse: CA, upon hire Preferred Bachelors Of Nursing and Utilization Management...: Sunday-Saturday per dept needs Shift: Varies Category: Staff Nurse Share Job RN Transfer Center...
in Nursing or Social Work. Registered Nurse (RN) license preferred. Licensed (LVN or LPN) nurse acceptable. Two (2) year clinical..., current and discharging residents needs in area(s) of responsibility. Complete documentation as required. Performs utilization...
is granted as required by law. The LTSS Service Coordinator-RN is responsible for overall management of member's case..., and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks...
Planning or Utilization Management required. Education Current California RN License. BSN or Bachelors degree in health... and provide ongoing education to the health care team regarding the case manager’s role. Utilization Management The case...
progress of all open cases to the Medical Director, Director of Healthcare Services and Manager of Utilization Management. 16.... 6. Identifies Members who may need complex or chronic case management post discharge and warm handoff to appropriate...
required. Active Licensed Vocational Nurse (LVN) license to practice in the state of California required. Active Registered Nurse (RN... required. Preferably in the following related areas of responsibility: Grievances and Appeals, Utilization Management and/or Quality...