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Utilization Review Jobs in Los Angeles

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Search Results - Utilization Review Jobs in Los Angeles
apartmentGQR HealthcareplaceLos Angelesevent_available
Job Description GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in San Pedro, California. Job Description & Requirements  •  Specialty: Utilization Review  •  Discipline: RN  •  Start Date: 05/04...
apartmentLanceSoftplaceLos Angelesevent_available
experience  •  Experience in: ✔️ Care Coordination ✔️ Utilization Review ✔️ Discharge Planning  •  Strong experience with InterQual & EPIC  •  California Case Management experience REQUIRED  •  Background in MS, MS/Tele, ICU & some ER  •  Active CA RN License...
apartmentLanceSoftplaceLos Angelesevent_available
40 hours per week  •  Shift: 8 hours, days  •  Employment Type: Travel  •  Work Settings Acute Hospital Case Management/Utilization Review Admission Criteria Benefits Eligibility Care coordination Concurrent Review Continued Stay Reviews Determine...
apartmentUniversity of California San DiegoplaceLos Angeleslanguageappcast.ioevent_available
license issued by the State of California.  •  BLS at time of hire with commitment to get BART within six (6) months of hire date.  •  Minimum of 3 years inpatient acute care management experience.  •  Demonstrated utilization review/discharge planning...
apartmentHanker Systems IncplaceLos Angelesevent_available
PM)  •  Weekend Rotation: Every other weekend Job Description: We are seeking an experienced RN Case Manager for an acute care setting. This role requires strong expertise in care coordination, utilization review, and discharge planning. The ideal...
apartmentCentene Corp.placeLos Angeleslanguageappcast.ioevent_available
functions for the business unit.* Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.* Performs medical review activities pertaining to utilization review, quality assurance...
apartmentCatalytic SolutionsplaceLos Angelesevent_available
Manager, Registered Nurse/n  •  Shift: Day 5x8-Hour (08:00  •  16:30)/n- Experience Required: 2 years in acute medical Care Management/n- Skills Required:/n  •  Care Coordination/n  •  Utilization Review/n  •  Discharge Planning/n  •  Interqual and Epic experience...
apartmentOklahoma Complete HealthplaceLos Angeleslanguageappcast.ioevent_available
improvement activities.* Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.* Supports effective...
apartmentLanceSoftplaceLos Angelesevent_available
Case Management experience  •  Experience in: ✔️ Care Coordination ✔️ Utilization Review ✔️ Discharge Planning  •  Strong experience with InterQual & EPIC  •  California Case Management experience REQUIRED  •  Background in MS, MS/Tele, ICU & some ER  •  Active...
apartmentNavitasPartnersplaceLos Angeleslanguagetalentnest.comevent_available
the continuum of care  •  Perform discharge planning and utilization review  •  Collaborate with physicians, nurses, and allied health professionals  •  Ensure appropriate resource utilization and patient advocacy  •  Monitor patient progress and adjust care plans...
apartmentConcentra, Inc.placeLos Angeleslanguageappcast.ioevent_available
procedures, and performance standards and URAAC guidelines and state regulations. Responsibilities  •  Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work...
placeLos Angeleslanguageacentra.comevent_available
obligations.  •  Skilled in conducting utilization reviews and patient chart reviews with accuracy and timeliness.  •  Strong clinical assessment, analytical, and critical-thinking skills with the ability to apply evidence-based criteria.  •  Excellent written...
apartmentMotive CompaniesplaceLos Angeleslanguagesmartsearchonline.comevent_available
quality assurance reviews, and utilization reviews  •  Ensure compliance with HIPAA and state regulatory standards Financial and Operational Management  •  Monitor enrollments, service activity, and billing accuracy  •  Support budget planning and financial oversight...
placeLos Angeleslanguageicims.comevent_available
personnel as necessary.  •  Act as a patient advocate, ensuring dignity and confidentiality.  •  Demonstrate empathy and compassion for patient experience.  •  Advocate for evidence-based practices in case management and utilization review.  •  Safety...
apartmentNavitasPartnersplaceLos Angeleslanguagetalentnest.comevent_available
and hospital policies  •  Support appeals, denials, and utilization review processes  •  Coordinate complex discharges involving social, behavioral, and medical needs  •  Educate patients and families on care plans and post-discharge resources  •  Maintain accurate...
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