Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established... Required: At least 5 years of varied clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case...
Services and Supports (MLTSS) Nurse Specialist RN II applies advanced clinical judgment and critical thinking skills... to regulatory mandates that apply to Utilization Management (UM) and Care Management (CM). Collaborate with Skilled Nursing...
Specialist II utilizes clinical skills and training to perform essential functions of care management for identified and assigned..., Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse (RN);current...
Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible for the overall coordination of the Appeals... & Grievance (A&G) program for L.A. Care Health Plan members under the direct supervision and management of the A&G Nurse...