Utilization Review RN: Care Coordination & Case Management
Providence Health Plan Group
A leading healthcare organization is seeking a skilled professional to provide utilization review and coordinate care for members in California. The successful candidate will have a Nursing school degree and a California RN License. Key responsibilities include ensuring quality and cost-effective healthcare. Experience in utilization and case management is preferred. Providence offers a comprehensive benefits package including health care benefits, retirement plans, and paid parental leave. #J-18808-Ljbffr Providence Health Plan Group
Vacancy posted 3 days ago
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...California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical service... ...delivery. The ideal candidate has an active RN license and at least 2 years of experience in hospital or managed care settings. Competitive pay is offered, ranging...SuggestedHourly pay$74.29k - $111.43k
...Summary The Concurrent Utilization Review (UR) Nurse is... ...provided to members under a managed care health plan. The role... ...and continued stays, coordinating with healthcare... ...leadership for complex cases, denials, and escalated... ...- Registered Nurse (RN) with an active, unrestricted...SuggestedWork at office- ...Description Summary:**The RN Case Manager, in collaboration... ...plan of care for patients, determining... ...and retrospective case review. This position functions... ...recent experience in utilization review and/or discharge... ...Modifiable)****Care Coordination*** Works with the healthcare...SuggestedDaily paidShift work
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NeueHealth in California is seeking a Concurrent Utilization Review Nurse responsible for conducting clinical reviews to ensure the medical... ...necessity and appropriateness of services provided under a managed care plan. The role requires 2-3 years of clinical experience,...Suggested- ...Executive Service Corps is seeking an RN Case Manager-Pre Access in California. This... ...and facilitating admission reviews for acute patients. The ideal candidate... ...and has experience in an acute care setting. Responsibilities include coordinating patient transfers and ensuring...
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...Summary and Responsibilities Day Full Time RN Care Coordinator The RN Care Coordinator is... ...communication and collaboration with utilization management nursing physicians, ancillary departments... ...experience - or a Masters degree in Case Management or Nursing field in lieu of...Hourly payFull time- SCAN Group in California seeks a Medical Management Specialist-LVN to ensure quality care for members. The role involves managing complex medical cases and applying utilization management principles to support care coordination. To be successful, candidates must have a...Remote job
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Marin General Hospital is seeking an RN Case Manager to lead the development of patient care plans and ensure effective, efficient care. The role requires a... ...acute care setting. Responsibilities include care coordination, discharge planning, and collaboration with healthcare...Hourly pay$27.61 - $53.83 per hour
...includes assessing services to ensure compliance with regulations and optimizing member outcomes through effective collaboration and review processes. Candidates should have at least 2 years of relevant healthcare experience, strong communication skills, and proficiency...Hourly payWork at office- ...healthcare organization in California seeks a Case Manager to facilitate care for Cal Medi-Connect program members. The role involves coordinating services alongside health plan and... ...knowledge in case management, a licensed RN or LVN credential, and collaboration skills...
- ...s Best Hospitals. As a Per Diem Registered Nurse, Care Coordinator at Cedars‑Sinai you will be scheduled to work a minimum... ...Nursing required License/Certifications Valid CA RN license required Certified Case Management preferred or willing to obtain within 2 years time...Daily paidWork experience placementSeasonal workShift workWeekend work
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The Vital Care Case Manager is responsible for the assessment... ...Program. Current CA RN, or LVN license, current... .... 2-3 years of utilization or HMO experience preferred... ...’s benefit plan, and coordinates member benefits as... ...healthcare team (concurrent review, pre-authorization,...Hourly payFull timeRelocation packageFlexible hours$114.4k
Rehabcentre is hiring a Licensed Vocational Nurse (LVN) Case Manager in California, offering a competitive salary of $114,400 per year. In this full-time role, you will coordinate resident care, ensuring quality outcomes and interdisciplinary collaboration among healthcare...Full time- Medical Hill Healthcare Center in California is seeking a Licensed Vocational Nurse (LVN) Case Manager to coordinate resident care and improve patient outcomes. This full-time position is critical in ensuring continuity of care and collaborating with a dedicated interdisciplinary...Full time
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Marin General Hospital is seeking a full-time Social Work Case Manager (LCSW II) to join its Care Coordination team in California. The role involves leading the development of multidisciplinary plans of care for patients, ensuring quality outcomes, and acting as a liaison...Hourly payFull time- ...organization is seeking an exceptional LVN Case Manager to join their team in California. The role involves managing client cases, coordinating healthcare benefits, and promoting member... ...a chance to make a significant impact in care management, supporting individuals with...Remote job
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A healthcare organization in California seeks a full-time RN Care Coordinator responsible for managing patient care and discharge planning. The role focuses on communication and collaboration with medical teams to enhance patient transitions and outcomes. Candidates must...Hourly payFull time$51.88 - $76.28 per hour
...Director the nurse case manager manages clinical resource utilization and documentation affecting... ...Functions Reviews clinical information... ...members of the health care team in removing... ...disciplines to assist in coordination of patient care,... ...’ experience as a RN, or two (2) years’...Shift work- ...compassionate bridge between hospital care and hospice. This role includes conducting... ...assessments, educating families, and coordinating admissions with empathy and trust. The... ...experience, particularly in hospice or case management. Join VITAS and rediscover the heart of...
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## Medical Management Specialist, LVNApplylocations... ...977 as the Senior Care Action Network,... ...supporting the utilization management processes... ...service and concurrent review following... ...reviewer. Applies case management principles... ...care and service are coordinated.**You Will**Ensure...Hourly payRemote workMonday to Friday$85.7k - $128.54k
The Supervisor, Utilization Management (UM), reports to the... ...service and claims reviews. Supervise licensed and coordinator staff, ensuring... ...Promote quality patient care outcomes while... ...Handle escalated UM cases as required.... ...and unrestricted RN or LVN license in...Remote jobLocal area$26.41 - $51.49 per hour
...support for member clinical review processes specific to... ...through integrated delivery of care across the continuum.... ...collaboratively with the utilization and care management departments to provide ABA... ...for members. Develops and coordinates internal and external BHT...Hourly payWork experience placementLive inWork at officeLocal area$3,600 - $3,969 per week
...Services Supervisor, RN Department:... ...To: Health Center Manager FLSA Status: Exempt... ...the treatment and care of patients, including... ...or indirect care coordination and case management.... ...measures. Independently utilizes nursing judgement... ...ongoing nursing review meetings. Participates...Work at officeLocal areaFlexible hoursAfternoon shift- yourcommission is looking for a Case Manager Care Coordinator in California to oversee the care and service of patients from admission through discharge... ..., a minimum of two years in acute care nursing, and an RN State License. Experience in care management is preferred....
- A healthcare staffing agency is seeking an RN Case Manager to supervise LPNs and ensure compliance with Medicare... ...clinical quality standards and providing coordinated patient support. Ideal candidates will have Chronic Care Management experience. Join a supportive team...Remote job
$51.31 - $78.76 per hour
Pay Range: CASE MANAGER, RN - $51.31 to $78.76 Job Summary The... ...responsible for screening, coordinating, and facilitating admission review of all acute patients.... ...Manager in an acute care setting or five years recent... .... Advanced experience utilizing InterQual required....
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