Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Clinical Utilization Review Case Manager

Torrance-Memorial-Medical-Center

Torrance-Memorial-Medical-Center seeks an experienced Utilization Review Case Manager (RN) to review patient charts and validate appropriate levels of care using InterQual/MCG criteria. The UR CM secures payer authorization and communicates with payers throughout the stay, ensuring compliance with CMS and Joint Commission standards. The role involves collaborating with RN Case managers, physicians, and external case managers, documenting thoroughly, and supporting denial prevention and discharge #J-18808-Ljbffr Torrance-Memorial-Medical-Center

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Clinical Utilization Review Case Manager in Torrance, CA vacancy
  • $56.39 - $87.25 per hour

    Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the...  ...secures authorization for the patient's clinical services through collaboration and... 
    Suggested
    Contract work
    Night shift

    Torrance Memorial Medical Center

    Torrance, CA
    4 days ago
  • $47.2 - $63.45 per hour

     ...for the quality and resource management of all patients that are admitted...  ...the achievement of quality, clinical and cost-effective outcomes...  ...admission and concurrent review of the medical record for the...  ...least one year experience in case management, discharge planning... 
    Suggested
    Full time
    Part time
    Work experience placement
    Local area
    Shift work

    Prime Healthcare

    Lynwood, CA
    3 days ago
  • Origin Travel Nurses is seeking a Case Manager responsible for utilization review and case management in a hospital setting. You will perform chart reviews...  ...at admission, and document daily. This role requires clinical and case management experience, plus BCLS... 
    Suggested

    Origin Travel Nurses

    Torrance, CA
    3 days ago
  •  ...Case Manager Qualifications for Case Manager: The Case Manager...  ...Partners with medical staff, utilizes scientific evidence for best...  ...employee performance through the review of completed work assignments...  ...CA Registered Nurse Acute clinical experience Experienced in... 
    Suggested
    Temporary work
    Shift work

    Care Navigators On Demand

    Torrance, CA
    4 days ago
  •  ...Case Manager This position reports to the Director of Case Management...  ...Services. Performs chart reviews and quality assessments on all...  ...regarding criteria for Utilization Management. Provides documentation...  ..., direct‑hire, and non‑clinical professionals across hospitals... 
    Suggested
    Locum
    Immediate start
    Shift work

    Torrance Memorial Medical Center

    Torrance, CA
    1 day ago
  •  ...and integrity that you truly deserve. Job Description Minimum of recent 2 years combined case management or clinical experience providing direct patient care and utilization review/case management experience in an acute care environment Working knowledge in the use of... 
    Daily paid

    Platinum Healthcare Staffing, Inc.

    Torrance, CA
    5 days ago
  •  ...Nurse Case Manager Under the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, acting as a resource...  ...Act. Essential Functions: Reviews clinical information daily on each... 
    Full time
    Shift work
    Day shift

    Memorial Hospital of Gardena

    Gardena, CA
    13 hours ago
  • Role Summary The Case Manager is a vital member of the Interdisciplinary Care Team and collaborates...  ...with the Primary Care Provider and utilizing clinic resources. Conduct in-clinic, at-home...  ...discharges and transitions of care. Review medical test results and collaborate... 
    Immediate start
    Monday to Friday

    TALENT Software Services

    Carson, CA
    3 days ago
  •  ...Registered Nurse (Case Manager)The case manager performs the primary functions of assessment...  ...health care plans and optionsMake clinical decisions for routine patient careAccurately...  ...consider 1.5 years)Experience with Utilization Review and Discharge PlanningExperience with... 

    E-talentnetwork

    San Pedro, CA
    1 day ago
  • $34.77 - $36.6 per hour

     ...medical, dental, vision and retirement benefits Job Summary The Clinical Case Management Team provides clients with the highest levels of acuity and...  ...Assigns and monitors case load of the team: Review daily referrals and screenings of potential clients. Designates... 
    Hourly pay
    Work at office
    Local area

    Volunteers of America Los Angeles

    Compton, CA
    4 days ago
  • $34.77 - $36.6 per hour

     ...vision and retirement benefits JOB SUMMARY AND PURPOSE The Clinical Case Management Team provides clients with the highest levels of acuity and...  ...RESPONSIBILITIES Assigns and monitors case load of team: Review daily referrals and screenings of potential clients.... 
    Work at office
    Local area

    Voala

    Compton, CA
    4 days ago
  • $38 - $41 per hour

     ...placing talented healthcare professionals in clinical and non-clinical positions with some of...  ...are aggressively seeking an Ambulatory Case Manager RN to join a large Healthcare...  ...prospective, concurrent and retrospective review of active patient care. Coordinates treatment... 
    Private practice
    Monday to Friday
    Flexible hours
    Shift work

    Healthcare Support Staffing

    Torrance, CA
    4 days ago
  • $51.19 - $64.92 per hour

     ...physician and offer 24-hour clinical care seven days a week...  ...and ensures optimum utilization of resources, service...  ...with external review agencies. Provides ongoing...  ...the quality of patient management and satisfaction, to promote...  ...of functions of case management, utilization... 
    Full time
    Work at office

    Kindred Hospital Paramount

    Paramount, CA
    1 day ago
  •  ...Job Title: RN Case Manager Los Angeles, CA Region Now Hiring: RN Case Manager Los Angeles...  ...Responsibilities May assist supervisor/manager in review of reports, staff development....  .... Individuals who conduct initial clinical review possess an active, professional license... 
    Full time
    Work at office
    Local area
    Immediate start

    Crawford & Company

    Gardena, CA
    3 days ago
  • $53 - $75 per hour

     ...Inpatient Care Manager Salary Range: $53.00 - $75.00 per hour Based on an initial review of member care needs at the time of admission...  ...discharge. Apply approved clinical criteria to monitor...  ...continuity of care. Presents cases and participates in discussion... 
    Hourly pay
    Local area

    Torrance Memorial

    Torrance, CA
    4 days ago
  • $61.98 - $86.73 per hour

     ...RN, Case Manager III (UR) Title: RN Case Manager III Location: Long Beach Department...  ...for education, monitoring, utilization and evaluation of medical outcomes....  ...documentation, including but not limited to the Clinical Pertinence Review Form. The case manager has the... 
    Full time
    Contract work
    Shift work

    MemorialCare

    Long Beach, CA
    2 days ago
  • $120k - $150k

     ...through exceptional care and meaningful relationships. As our Clinical Director, you'll have the chance to lead with purpose, guiding...  ...satisfaction. Qualifications: Experience in leading and managing clinical teams, with a focus on fostering a culture of accountability... 

    Keen Home Care & Homes

    Long Beach, CA
    9 days ago
  • $157.21k - $231.13k

     ...USA The System Director of Case Management is responsible for the overall...  ...-quality care that meets clinical, operational, and regulatory...  ...management program at Pipeline utilizing a system approach Oversee...  ...further information, please review the Know Your Rights notice... 
    Local area

    Avanti Hospitals

    Gardena, CA
    5 days ago
  • Duties And Responsibilities The Case Manager will assist patients to understand recommendations...  ...(billing, medical records, etc.). Review superbill forms. Maintain and...  ...as directed by supervisor (Clinic Manager/LVN). Utilization of CAIR, and VFC and other systems as... 

    Via Care Community Health Center

    Bellflower, CA
    2 days ago
  • $68.65k

    Senior Surrogacy Case Manager / Program Coordinator Over The Rainbow Surrogacy Full-Time |...  ...postpartum needs. Communicate with IVF clinics, attorneys, escrow companies, insurance...  ...the GC clearance process, including: Reviewing prospective GC applications and qualifications... 
    Full time
    Remote work
    Monday to Friday

    Palo Verde Community College District

    Hermosa Beach, CA
    5 days ago
  • $55 - $60 per hour

     ...growth opportunities.We're hiring a RN Case Manager – a compassionate and skilled clinician...  ...with a Hospice Care LeaderYou lead with clinical expertise, empathy, and strong organizational...  ...by Silverado and is available for review upon request to ensure compliance with California... 
    Full time
    Monday to Friday
    Shift work

    IntelyCare

    Torrance, CA
    4 days ago
  • TEEMA Solutions Group invites a dedicated Registered Nurse Case Manager to join our care team in Carson, CA. This hybrid clinic & field-based role concentrates on improving care outcomes for an assigned elder patient panel, collaborating with PCPs and an interdisciplinary... 

    TEEMA Solutions Group

    Carson, CA
    1 day ago
  • $55.56 - $85.96 per hour

     ...in Torrance, California is seeking a Case Management Nurse II to support the interdisciplinary...  ...patient caseload, integrate utilization management, and provide discharge planning...  ...will have a nursing degree, relevant clinical experience, and a Registered Nurse License... 
    Hourly pay

    Torrance Memorial Medical Center

    Torrance, CA
    3 days ago
  • Volunteers of America Los Angeles is seeking a Lead Clinical Case Manager to supervise a high-acuity caseload and provide coordinated care, counseling, and planning. The role combines administrative duties with field/outreach work to support re-entry and stability for clients... 

    voalacs

    Compton, CA
    3 days ago
  • $60.07 per hour

    Position Summary The RN Case Manager is responsible for performing clinical assessment and reassessment of acute care Inpatients for the purpose of performing utilization review, resource management and safe discharge planning. The RN Case Manager prioritizes, plans, organizes... 
    Full time
    Local area
    Immediate start
    Relocation package

    Southern California Hospitals

    Culver City, CA
    3 days ago
  • Alta Hospital in California seeks an RN Case Manager to assess and reassess acute inpatients for utilization review, resource management, and safe discharge planning. You...  ...transitions of care. The role emphasizes clinical competence, timely reviews, and effective communication... 

    Southern California Hospitals

    Culver City, CA
    3 days ago
  •  ...Clinical Care Manager – CA We are seeking a Clinical Care Manager – CA to join our team at Independent...  ...in clinical care coordination or case management. Requires knowledge of...  ...with insurance providers and case management teams to optimize resource utilization.... 

    Independent Living Systems LLC

    Torrance, CA
    4 days ago
  • $24 - $26 per hour

     ...Case Manager Long Beach, CA Case Management Services form the core of the services for people who are homeless...  ...plan, and conduct comprehensive assessments to be reviewed and updated quarterly. Learn and utilize the project's database software (CHAMP/HMIS/APRICOT... 
    Hourly pay
    Permanent employment
    Flexible hours
    Afternoon shift

    Century Housing

    Long Beach, CA
    5 days ago
  •  ...or lack thereof through comprehensive case management and integrated social service programs....  ...their individual goals Identify and utilize client strengths to increase self-efficacy...  .... St. Joseph center invites you to review the current "EEO is The Law" poster as... 
    Permanent employment
    Full time
    Flexible hours
    Afternoon shift
    Early shift

    St. Joseph Center

    Culver City, CA
    3 days ago
  • $150k

     ...Job Description Position SummaryThe Manager of Case Management is accountable for overseeing...  ...to the Facility(s). Attends the Utilization Management Committee. Under the direction...  ...and met.Collaborates effectively with clinical and administrative leadership, physicians... 
    Full time
    Local area
    Immediate start

    Southern California Hospitals

    Culver City, CA
    9 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Clinical Utilization Review Case Manager. Be the first to apply!