Utilization Review Nurse Jobs in Anaheim, California

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

Jobs 1 to 20 of 26
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...
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...
CyberCoders Matching Great People with Great Companies Learn more about CyberCoders Utilization Management RN LVN La Habra, CA; Fullerton, CA Full-Time $70,000 - $95,000 Posted 4/18/2014 Frank Molina is recruiting for this position. Email your resume to Frank Apply Job Details RN LVN Oncology Utilization Management Nurse UM RN LVN M-F Dayshift Great opportunity for a truly gifted Registered Nurse...
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...
Position Description: We are currently seeking a Utilization Review Supervisor for our Anaheim, CA location. This is a Work From Home position, but candidate must have flexibility to report into the office. Main responsibilities will include but are not limited to: • Responsible for the ongoing training, supervision and evaluation of professional staff performing Utilization Review services, inc...
Description: AppleCare Medical Group was formed in Lynwood, California, 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-p...
Description: Want to learn more before applying for this role? Click here to view the Realistic Job Preview: UHC_Telephonic_UM_Nurse.pdf UnitedHealthcare currently has a NEW opportunity available for a Preservice Review Nurse in our Cypress, CA office. The successful candidate will be responsible for applying new medical necessity guidelines to Prior Authorization Requests and responding to Provid...
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...
Bilingual RN Manager of Utilization Management - Managed Care Los Angeles, CA * Candidates must be fully bilingual in English & Spanish. * Job Summary: The role of the RN Manager of Utilization Management is to promote the quality and cost effectiveness of prior authorization and concurrent review functions. This person is responsible for management and oversight of daily managerial operations per...
Description: Monday - Friday! Business Hours! Clinical Appeals! Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the...
Description: The adult/ geriatric Nurse Practitioner functions independently, but with the Supervising Physician collaboration and back-up. The NP/ Physician Clinical Team will visit a variety of skilled nursing facilities and provide medical management to skilled and custodial nursing patients. The NP will be responsible for periodic night call, as well as rotation on weekend call. Thorough under...
The Discharge Planner, in conjunction with other members of the health care team is accountable for timely coordination of quality health care services to meet the patient's health care needs across the continuum of care. This position requires knowledge of the development stages as services are provided to infants, children, adolescent, pediatrics, adult and geriatric populations. The Discharge P...
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...
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...
RN Case Manager - Medical Center - 40 hours per week About the Job: Concurrent Review, Level of Care, Severity of Illness (SI), Intensity of Service (IS) and Discharge planning Process TARS, treatment authorizations requests as needed Coordinate chart reviews for quality reports and clinical procedures InterQual or Milliman Requirements Registered Nursing License (CA) About the Agency: Managed Car...
Bilingual RN Case Manager - Managed Care Los Angeles, CA * Candidates must be fully bilingual in English & Spanish. * Job Summary: As a member of the medical management team, the Nurse Case Manager plays an integral part in the coordination of care assessing the member’s condition and providing them the necessary resources, options, and coordination for a healthy care outcome. The primary responsi...
System Director of Care Management UR Case Management To apply via your mobile device, use the following URL: CLICK HERE TO VIEW OR APPLY ON A MOBILE DEVICE Southern California My client is hospital system that is part of one of the largest healthcare systems in the country. They are one of the nation's largest and most respected healthcare management companies, operating through its subsidiaries...
Position Description: We are currently seeking a Branch Manager in our Utilization Management (UM) division for Anaheim, CA. • Responsibilities will include but are not limited to: • Provision of overall management and supervision of comprehensive utilization management (UM), incorporating the strategies of cost containment, appropriate utilization of services and case management in a cooperat...
Job Description: This RN Utilization Review Position Features: ? Steady Hours ? Great Work/life Balance ? Awesome Work Culture ? Great Pay to $85K Well established company has an Immediate need for RN/UR seeking steady hours, with great work/life balance. Understanding of generally accepted medical practices and certified case management (CCM) preferred will be keys to success in this stable, fami...
Covenant Care owns and operates skilled nursing facilities and a therapy services company. Our “family” includes over 8,200 professionals running 53 skilled nursing facilities, 4 assisted living facilities, and a therapy services company in 7 states. Our goal is to provide compassionate and comprehensive care in a comfortable and safe environment. We provide 24-hour care ranging from short-term th...
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Healthcare Career Tools

Nurse Manager

Salaries

$53,600.00 - $103,400.00
Typical Salary for Nurse Manager in Anaheim
(310 Respondents)
Source: Monster.com Careerbenchmarking Tool

Education / Training

Bachelor's
40.7%
Master's
30.8%
Associates
22.9%
(214 Respondents)
Source: Monster.com Careerbenchmarking Tool

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