…of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident

…(RN) * Five years of acute care clinical experience and two years of utilization review experience _Preferred:_ * Basic Life Support (BLS) certification as a

…departmental support to achieve metrics for conditions of participation, including utilization review , medical social work, discharge planning, crisis mental

Utilization Management Admissions Liaison RN II (After Hours Evening) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US,

…recommend changes to budgets to the Regional Facility Administrator. Monitor and review financial and utilization results. Participate in the strategic planning

…applicable criteria, and analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with State, Federal and NCQA

…patient satisfaction and safety measures. **FINANCE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use,

…high-risk patients, the Discharge/TOC pharmacist also provides full discharge medication review and counseling. The position will manage populations of patients who

…patient's reason for visit, weight, vital signs, visit screening information, medication review , and pertinent information for provider. + Sets up examination and