Utilization Review RN - Care Coordination & Cost-Effectiveness
Providence Health and Services
Providence Health and Services is looking for a dedicated Registered Nurse to provide utilization review and care coordination to enhance quality care. The ideal candidate will be a nursing graduate with a California RN License and at least three years of experience in utilization management. The position offers a robust benefits package including health care, retirement plans, and paid time off. #J-18808-Ljbffr Providence Health and Services
- ...is seeking a qualified Registered Nurse in Glendale, California to provide utilization review and care coordination. The ideal candidate will be a nursing school graduate with a California RN license and have a minimum of 3 years in utilization and case management. You...Suggested
- ...Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation...SuggestedWork at office
- Responsibilities Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost‑effective care to the members. Required Qualifications Nursing school graduate. California Registered Nurse License...SuggestedMinimum wageWork at officeLocal areaShift work
$74.29k - $111.43k
...entitled to high‑quality, coordinated care. By uniquely aligning... ...The Concurrent Utilization Review (UR) Nurse is responsible... ...support timely and effective discharge planning.... ...Education: Registered Nurse (RN) with an active,... ...determinations. Cost savings achieved through...SuggestedWork at office- ...Medical Foundation, contributing to the coordination of care and promoting quality, cost-effective solutions for members. As a Registered Nurse, you’ll utilize your expertise in case management... ...management, a California RN License, and a passion for patient-focused...Suggested
$88.85k
...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management... ...Max.) Established in 1997, L.A. Care Health Plan is an independent public... ...self-direction. Ability to work effectively with diverse teams in cross-...Full time- Air Combat Effectiveness Consulting Group, LLC in Monterey Park is seeking a Case Manager RN or LVN to join our Utilization Review Department. This per diem position involves coordinating care for patients, conducting admissions, and liaising with health plans to ensure...Daily paid
- ...to-day operations of the Utilization Management Program in the... ...Medical Center. Ensures cost effective and quality patient care by appropriate utilization... ...disciplinary teams to plan and coordinate care across the continuum... ...regarding utilization review, care coordination,...Local area
$47.2 - $63.45 per hour
...and compassionate medical care. St. Francis is... ...the advocate, promoting cost containment and demonstrates... ...quality, clinical and cost effective outcomes and to perform... ...admission and concurrent review of the medical record for... ...Social Worker. However, RN Case Manager preferred.3...Full timePart timeWork experience placementLocal areaShift work- Ocean State Job Lot is seeking an RN for Utilization Management in Los Angeles, CA. This role involves coordinating care submissions and documentation for patient admissions... ...teams, handle e-TAR processes, and require effective communication skills. Preferably, candidates...
$88.85k
...Utilization Management Admissions Liaison RN II Job Category: Clinical... ...in 1997, L.A. Care Health Plan is... ...for receiving/reviewing admission requests... ...for facilitation/coordination of patient transfers... ...impact on the cost of health care... ...the most cost effective manner without...Full timeAll shiftsShift workNight shiftAfternoon shift$116.3k - $264.6k
...quality, patient-centered care. UCLA Health is... ...dynamic and experienced Utilization Management Assistant... ...about care coordination, utilization management... ...Support utilization review activities for hospital... ...patient experience, and cost-effective care delivery Promote...- ...and Responsibilities As our RN Care Coordinator, you will be a central... ...progression of care and appropriate utilization of inpatient resources... ...reliability test for Utilization Review product(s) used. Able to... ...skills. Collaborate effectively with multiple stakeholders....Relocation package
$27.61 - $53.83 per hour
...for clinical member services review assessment processes.... ...through integrated delivery of care across the continuum. Contributes... ...to provide quality and cost-effective member care. Essential Job... ...care model. • Adheres to utilization management (UM) policies and...Hourly payContract workWork experience placementWork at office$46.07 - $67.73 per hour
...Bed Control Coordinator Full Time RN Job Category: Registered Nurse... ...available patient care units, coordinating emergency... ...and family members. Utilizes white boards for... ...and maintains effective relationships with customers... ...information, please review the Know Your Rights...Hourly payFull time- L.A. Care Health Plan in Los Angeles is hiring a Utilization Management Claims Review Nurse RN II responsible for conducting clinical reviews of medical claims. The position requires a minimum of 5 years in clinical nursing, with experience in Medi-Cal and Medicare managed...
- ...Manager/Clinical Coordinator. Registered Nurse... ...Registered Nurse (Rn) Assesses, Plans,... ...Individual Patient Care On A Nursing Unit/... ...Team. Evaluates The Effectiveness Of The Plan Of Care... ..., Resource Utilization, And Staff And Self... ...Outlined In Performance Review. Performs Other...Temporary workFlexible hours
$52.25 - $80.99 per hour
MLK Community Healthcare is looking for an RN Utilization Management to oversee the coordination of care submissions and manage clinical denials. The role requires an Associate's Degree in Nursing, with preference for a BSN, and a California Registered Nurse License. Responsibilities...Hourly pay- ...purpose of your job position as Care Coordinator Nurse is to provide direct... ...care that is safe, timely, effective, efficient, equitable, and... ...Execute the patient care plan. Utilizing your direct care nursing... ...equitable, and resident-centered. Review medical records of each...Immediate start
$60 - $65 per hour
...overseeing patient care activities in... ...learning. Coordinates with medical staff... ...team to utilize resources considering... ...to facilitate effective inventory... ...patient assessment, reviews surgeon preference... ...an organized, cost effective and... ...Registrations ~ RN License; ACLS,...Hourly payFull timeCasual workWork at officeRelocation packageFlexible hours- ...The CARE COORDINATOR , in collaboration with the multidisciplinary team... ...healthcare to promote safe, cost-effective, quality outcomes.... ...individualized care plans utilizing evidence-based tools to ensure... ...care. Performs utilization review functions to guide billing...
- ...POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaison for... ...denials management, and the UM process. It coordinates care submission relating to the process of... ...hospital stays, and discharge review that determine medical necessity. The...Full time
$46.07 - $67.73 per hour
...Wound Care Coordinator RN (Sub-Acute/FT/Days) Job Category: Registered Nurse... ...and family members. Utilizes white boards for patient communication... ...; establishes and maintains effective relationships with customers... ...further information, please review the Know Your Rights notice...Full timeRelocation packageShift work- ...There are five new RN vacancies at the... ...We are seeking a Utilization Management Nurse to... ...be responsible for reviewing patient files and... ...for efficiency and effectiveness. Your role will be... ...patients under our care are receiving the... ...patient management and cost assessments...For contractorsWork at officeImmediate startRelocation packageMonday to FridayFlexible hours
- ...There are five new RN vacancies at the... ...We are seeking a Utilization Management Nurse to... ...be responsible for reviewing patient files and... ...for efficiency and effectiveness. Your role will ensure... ...under our care are receiving the... ...patient management and cost assessments. Qualifications...Work at officeRelocation packageFlexible hours
- ...hospital, wound care medical office and... ...the unit receive cost effective, professional care... ...Nurse (RN) licensure in the... ...personnel. Initiates and coordinates individual and team... ...most effective utilization of skills and abilities... ...and breaks. Reviews and takes action...Full timeWork experience placementWork at officeNight shift
- Neuehealth is seeking a Concurrent Utilization Review Nurse in Los Angeles, CA. This vital role involves conducting real-time clinical reviews... ...the medical necessity of healthcare services under managed care health plans. Responsibility includes collaborating with healthcare...
- ...an experienced nurse to assess and coordinate patient care in a collaborative environment. Responsibilities... ...care plans and performing utilization reviews to ensure high-quality care. The... ...skills, and the ability to work effectively with interdisciplinary teams. This...Shift work
$75k - $80k
...Home Care Coordinator (LVN/RN) Alhambra, CA About the Role Under the... ..., and referrals, ensuring effective communication with participants... ...to subcontracted agency. Reviews service confirmation for... .... Conducts QI and Utilization Management activities, tracking...Live in$71.11 per hour
...RN Care Coordination Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit... ...progression of care and appropriate utilization of inpatient resources using... ...to manage multiple tasks or projects effectively Ability to work independently as needed...Full timeFor contractorsLocal area
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