Jobs

9 results

All jobs posted within the past 30 days.

RN Utilization Management Oversight & Compliance Specialist - FT - 350 - Los Angeles

The Utilization Management Oversight & Compliance Specialist, RN is responsible for assuring that the UM Department is in compliance with all UM regulatory requirements and new legislation through the maintenance of required policies/procedures/workflows/ processes/audit ...

RN Care Management Specialist - FT - 343 - Los Angeles

The Care Management Specialist, RN is primarily responsible for the overall coordination of the Direct Lines of Business programs for L.A. Care Health Plan members. Responsibilities include program development, technology implementation and integrity, ensuring regulatory ...

RN FSR Nurse Specialist - FT - 824 - Los Angeles

Conducts face-to-face visits with our high-membership physicians to provide feedback, data, and education on programs and facilitates changes to improve quality of care and service to members. Conducts various types of site reviews of PCP and ...

Care Manager - FT - 704 - Los Angeles

The Manager, Care Management/Medical Management is directly responsible for the oversight and monitoring of care management functions, organization, direction and staffing of LA Care's Case Management function(s) including but not limited to Complex Case ...

RN Utilization Management Specialist - FT - Los Angeles - 346

Facilitation, coordination and approval of medically necessary referrals  for direct lines of business (MCLA, Healthy Families, Healthy Kids) that meet established criteria. Assures timely and accurate determination and notification of referrals and reconsiderations based on the ...

Senior Director, Quality Improvement - FT - 628 - Los Angeles

The Senior Director, Quality Improvement is directly responsible for the management, planning, organization, budget, direction, staffing and development of L.A. Care's Quality Improvement department.  Functions include but are not not limited to: Accreditation and/or ...

Utilization Management Oversight Nurse Specialist - Per Diem - Los Angeles - 355

The Utilization Management Specialist Position ensures compliance of the participating physician groups (PPGs) with regulatory, contractual and LA Care requirements. The UM Specialist is responsible for performing annual and focused audits and continuous monitoring activities. This ...

RN Clinical Assurance Compliance Nurse Specialist - FT - 354 - Los Angeles

The Compliance Nurse Specialist is responsible for the review of regulatory, contractual and accreditation standards to ensure Health Care Services Department policies are in compliance and in operation.  The position works closely with Regulatory Affairs and ...

Lead Care Management Specialist - FT - 510 - Los Angeles

The Care Management(CM) Specialist Team Lead position functions as the lead of Care Management Specialists in the Care Management MCLA Department, in support of the Care Management Supervisor.  Demonstrates and reinforces in-depth knowledge of the ...

Robert Noakes