- Cottage Health (Goleta, CA)
- …Utilization Review Manager , Registered Nurse for their Clinical Denials and Appeals department responsible for the overall management of utilization ... department . As an active member of the Utilization Review Committee, the manager will regularly... manager will regularly report on outcomes of utilization review, denials and appeals . The … more
- BSF Talent Recruitment (Los Angeles, CA)
- About the job Retail Warehouse Manager (Bilingual in Chinese and English) Job brief Our client specializes in offering a diverse array of affordable lifestyle ... beauty items, stationery, and electronics. Known for its trendy aesthetics, it appeals primarily to a young, urban audience. The shopping experience is enhanced… more
- AHMC Healthcare (Daly City, CA)
- …skills which reflect nursing standards. Knowledge of current utilization /quality management principles, techniques and procedures to include proficiency ... from care coordinators manages the timeliness and accuracy of reviews and appeals for denied cases. 15 Monitors care managers' collaboration with the… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department : CSC Appeals & Grievances Location: Los Angeles, ... net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances...in a manner consistent with regulatory requirements from the Department of Managed Health Care, Department of… more
- Elevance Health (Cerritos, CA)
- … Analyst I** is an entry level position in the Enterprise Grievance & Appeals Department that reviews, analyzes and processes non-complex pre service and post ... **Title: Grievance/ Appeals Analyst I** **Virtual:** This role enables associates...requirements. + As such, the analyst will strictly follow department guidelines and tools to conduct their reviews. +… more
- Sharp HealthCare (San Diego, CA)
- …documents as appropriate in the electronic medical record and provides information to the department head as indicated. + Utilization review and utilization ... **Facility:** Sharp Memorial Hospital **City** San Diego ** Department ** **Job Status** Regular **Shift** Day **FTE** 1...1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager … more
- Stanford Health Care (Palo Alto, CA)
- …waiting to be discovered. Day - 12 Hour (United States of America) Department : Social Work Outpatient Commitment: Part-time (0.6 FTE) Schedule: This role will ... Background in Behavioral Health with Pediatric Patients - Experience in an Emergency Department Why work at Stanford Medicine | Stanford Health Care (SHC)? *… more
- Alameda Health System (San Leandro, CA)
- San Leandro Hospital Case Manager RN, Per Diem, Days, 8hoursFeatured Job + San Leandro, CA + San Leandro Hospital + SLH Social Services + Services As Needed / Per ... #:42214-31299 + FTE:0.01 + Posted:Today **Summary** **Job Summary:** The SLH Case Manager RN is responsible for providing comprehensive case management services to… more
- Sharp HealthCare (San Diego, CA)
- …leadership and direction to the functions within the Medical Management + Department ( Utilization /Cost Management and Quality Management) + Responsible for and ... **Facility:** Health Plan **City** San Diego ** Department ** **Job Status** Regular **Shift** Day **FTE** 1...+ Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager… more
- Sharp HealthCare (La Mesa, CA)
- …as appropriate in Cerner and Allscripts Care Management and provides information to the department head as indicated. + Utilization review and utilization ... **Facility:** Grossmont Hospital **City** La Mesa ** Department ** **Job Status** Per Diem **Shift** Day **FTE**...0 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager … more
