Utilization Review Nurse Jobs in Anaheim, California

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24 Anaheim, CA Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 24
This is a position that focuses on utilization review including assessment of medical records for appropriateness, level of care provided. You will assess utilization of treatment, modalities, medications, services and application of treatment protocols. A team approach with other members of internal staff is important. Requirements: California Nurses license, Registered Nurse (RN) Utilization Rev...
Position Description: We are currently seeking a Utilization Nurse Reviewer for the Anaheim, CA area. Provision of comprehensive Utilization Management, incorporating the strategies of cost containment, appropriate utilization of services and Case Management in a cooperative effort with other parties which helps address the issues of access to quality healthcare services at an affordable cost. •...
Case Manager Registered Nurse (RN) Full Time, 40 Hours Per Week About the Job: Concurrent review and analysis of inpatient records to determine if the patient's admission and continued hospital stay triggers any pre-defined quality indicators. Utilization review including assessment of medical records for appropriateness, level of care provided. Assess utilization of treatment, modalities, medicat...
Description The LVN/LPN Case Manager is responsible to conduct medical necessity screening and work collaboratively with the interdisciplinary team to provide care coordination for patients under the direction of a Registered Nurse and in compliance with evidence-based practice and regulatory requirements. This position complies with the scope of services defined by the Licensed Vocational /Practi...
Description The LVN/LPN Case Manager is responsible to conduct medical necessity screening and work collaboratively with the interdisciplinary team to provide care coordination for patients under the direction of a Registered Nurse and in compliance with evidence-based practice and regulatory requirements. This position complies with the scope of services defined by the Licensed Vocational /Practi...
Description: AppleCare Medical was formed in in 1996. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctorsâbut the mission has remained the same. Today, AppleCare Medical Group is comprised of hundreds of board-certified private-practice, independent physic...
Description: Prior Authorization! Nurse! Cypress, CA! There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) Due to continued growth, we are looking for t...
Description The Case Manager will assess admission necessity utilizing the IQ SI/IS criteria. Review date will be assigned. If treatment plan does not meet criteria, the UR nurse will refer case to attending physician. If no determination, the UR nurse will refer the case to the Medical Director. The Case Manager will perform the initial IQ and clinical review, within one working day of admission...
Description The Case Manager will assess admission necessity utilizing the IQ SI/IS criteria. Review date will be assigned. If treatment plan does not meet criteria, the UR nurse will refer case to attending physician. If no determination, the UR nurse will refer the case to the Medical Director. The Case Manager will perform the initial IQ and clinical review, within one working day of admission...
DescriptionImplements and manages the Clinical Claims Review process for Coast Healthcare Management (CHM), and insures that policies and procedures are maintained while adhering to state and federal regulations. Qualifications Current CA RN license 3+ years experience Three to five years experience in Utilization Review, Medical Coding or Health Experience preferred Requires comprehensive knowled...
RN Case Manager - Medical Center About the Job: Responsible for assessing, planning, implementing, and evaluating the needs of patients for discharge planning and utilization review. Level of Care, Length of Stay, Continued Stay Reviews Coordinate utilization management, care facilitation, and discharge planning Coordinate discharge planning with physicians, nursing, and social services, patient a...
Guardian Angel Home & Hospice Care is now hiring for LVN's for the LA COUNTY area for their Santa Ana, CA location. (SURRONDING CITIES INCLUDE ORANGE, TUSTIN, HUNTINGTON BEACH, WESTMINSTER,SAN CLEMENTE, IRVINE,LAGUNA NIGUEL, MISSION VIEJO, LAGUNA BEACH, SAN JUAN CAPISSTRANO, & COTO DE CAZA) Must have a minimum of one (1) years Home Care experience! Job Summary: Provides skilled professional nursin...
Ambulatory Case Manager – Office Setting Duties: Responsible for the care management (coordination of outpatient care) of members with catastrophic illnesses and the chronically ill while ensuring that quality standards are met by using clinical judgment to evaluate and assess. Apply case management concepts, principles, and strategies to develop a Plan of Care (Care Plan) that addresses the membe...
Hospital, Inpatient RN Case Manager / Care Coordinator The Job: Concurrent Review Utilization Review Discharge Planning Authorizations (TARS) Case Management from Admission to Discharge Ability to: Responsible for assessing, planning, implementing, and evaluating the needs of patients for discharge planning and utilization review. Level of Care, Length of Stay, Continued Stay Reviews Coordinate ut...
Position Description: We are currently seeking a Nurse Reviewer/Telephonic Case Manager for the Anaheim, CA area. Provision of comprehensive Utilization Management, incorporating the strategies of cost containment, appropriate utilization of services and Case Management in a cooperative effort with other parties which helps address the issues of access to quality healthcare services at an affordab...
Description: For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The Clinical RN Document Improvement Specialist - (CDS) is responsible for providing CDI program oversight and day to day CDI...
Our leading healthcare client in East LA, is looking to hire, fulltime, the below position. Please reply to ***** for immediate consideration. This is a fulltime position, direct with client. ManagerMedical Management 2. Job Duties: -Oversees referrals and authorizations of outpatient and inpatient clinical care coordination functions. -Ensures compliance with regulatory req...
Description: For those who want to invent the future of health care, here's your opportunity! We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. Responsible for providing leadership and administrative oversight, program development, implementation, and evaluation of UM Prog...
Description: For those who want to invent the future of health care, here's your opportunity! We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. Responsible for providing leadership and administrative oversight, program development, implementation, and evaluation of UM Prog...
Description: For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The Clinical RN Document Improvement Specialist - (CDS) is responsible for providing CDI program oversight and day to day CDI...
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Healthcare Career Tools

Nurse Manager

Salaries

$53,040.00 - $103,400.00
Typical Salary for Nurse Manager in Anaheim
(311 Respondents)
Source: Monster.com Careerbenchmarking Tool

Education / Training

Bachelor's
40.9%
Master's
30.7%
Associates
22.8%
(215 Respondents)
Source: Monster.com Careerbenchmarking Tool

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