in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned...Job Description Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM...
: Prepare and submit appeals to third party payers Recordkeeping: Maintains appropriate records of the Utilization Review... psychiatric evaluations, consults, and lab results Requirements: Preferred; Current license as RN, LVN/LPT, LCSW Preferred...
: Four years of experience Utilization review, case management, discharge planning experience Bilingual English/Spanish... from inpatient admission to discharge. MINIMUM QUALIFICATIONS: Bachelor's Degree in Nursing Current California RN license...
or comparable Case Management experience. Driver's License - CA Department of Motor Vehicles California Registered Nurse (RN... and utilization management information is clearly and concisely communicated within the OON Data Base that includes current status...
(RN) - CA Board of Registered Nursing -REQUIRED AHA Basic Life Support for Healthcare Professional (AHA BLS Healthcare...) - American Heart Association -REQUIRED Preferred Qualifications Bachelor's Degree in Nursing RN experience in related...
. Demonstrates compliance with facility-wide Utilization Management policies and procedures. Coordinates UR compliance with Quality... high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews...
effective management of operations for the hospital and administration during regular and non regular business hours.... Required Qualifications 3 Years recent clinical experience. California Registered Nurse (RN) - CA Board of Registered Nursing...
. * Utilization review and utilization management The SRS RN CM II will: Conduct initial review at POE or within 24 hours... or case management experience 3 Years recent case management, utilization review, care coordination experience California...
, clinical experience California Registered Nurse (RN) - CA Board of Registered Nursing AHA Basic Life Support for Healthcare... in Nursing Leadership experience Two years recent ICU RN experience in an acute care setting Other Qualification...
Job Summary: Responsible for directing the administrative and business management of a single large department... management of operations, programs and services that add value and are integrated with nursing standards of practice, service...
to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining.../ population based management for patients in specifically defined geriatric or other specifically defined patient populations...
. Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge... including ongoing monitoring of an appropriate and effective person-centered care plan, member education and care management...
. Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge... including ongoing monitoring of an appropriate and effective person-centered care plan, member education and care management...
with significant organizational responsibility for the overall control of planning, staffing, budgeting, expense priority management... e.g. Compliance, Billing, and Quality Indicators. + Utilization of data to better understand their business unit...
with significant organizational responsibility for the overall control of planning, staffing, budgeting, expense priority management.... Compliance, Billing, and Quality Indicators. Utilization of data to better understand their business unit(s) opportunities...
Responsibilities Participate in Utilization Management/Case Management meetings to review and identify opportunities to improve...Company Description International SOS delivers customized medical and security risk management and wellbeing...
Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED AHA Basic Life Support for Healthcare Professional (AHA BLS... management All 90 day and annual performance reviews are completed within 30 days of due date. Assures employee files...
. Maintains documentation of care management assessment, intervention, follow up and evaluation of care pertinent to utilization... and financial information. * Utilization management Maintains correct knowledge and understanding of health plan benefit...
system in multi-service referral, program development, and quality care management. The CCM will develop strong relationships... acute care clinical experience in area of specialty. Previous clinical experience with cancer care, case management...
management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community... independent behavioral health or RN (with psychiatric/behavioral health) licensure is required. CEAP requirement does...
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