- Evolent (Sacramento, CA)
- …reviewers are supported by Physician clinical review staff (MDs) in the utilization management determination process. **What You Will Be Doing:** + Reviews ... Therapy you will be a key member of the utilization management team. We can offer you...outcomes. **Collaboration Opportunities: ** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- Dignity Health (Los Angeles, CA)
- …and assessment, case management , treatment planning, psychotherapy, and utilization review . **Qualifications** + One year's experience in an academic ... internship delivering outpatient mental health services. + MA degree in Social Work, Psychology or related field. + May answer pages, carry a beeper/pager + Spanish language skills preferred + Valid registration with the California Board of Behavioral Science… more
- Alameda Health System (Oakland, CA)
- …classification. + Accountable for Patient Care Coordination activities including system-wide Case Management , Care Coordination and Discharge Planning. + Aligns ... Case Management with AHS strategic and operational objectives. + Optimizes...Responsible for the coordination and support of the AHS Utilization Review Committee. + Responsible for overseeing… more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range ... current and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager… more
- Cedars-Sinai (Los Angeles, CA)
- …A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge of Joint Commission ... Are you ready to bring your advanced Health Information Management skills to a world-class facility recognized as one...information. Requests for accommodation will be considered on a case -by- case basis. Please note that only inquiries… more
- Sutter Health (Modesto, CA)
- …**SKILLS AND KNOWLEDGE:** + A broad knowledge base of health care delivery and case management within a managed care environment. + Comprehensive knowledge of ... Utilization Review , levels of care, and observation...Working knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery… more
- Elevance Health (CA)
- …or equivalent. Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... services in multiple states. **Preferred Skills, Capabilities, and Experiences:** + Utilization Management experience is strongly preferred. + Health insurance… more
- Alameda Health System (San Leandro, CA)
- …visitors, and volunteers. 8. Assures that the facility complies with all utilization review and case management requirements of Alameda County, AHS, and ... Physicians JGP ER + Full Time - Day + Management + $96.70 - $161.16 / Hour + Req...with Department Chair/designee. 16. Develops, reviews, and/or conducts personnel management for relevant physicians and APPs, in concert with… more
- Sharp HealthCare (San Diego, CA)
- …in-patient Care Management program that includes initial and concurrent review ; case management /discharge planning activities. Responsible for ... Bachelor's Degree Health care related field **Other Qualification Requirements** + Utilization , Case Management , or Quality Management certification… more
- CenterWell (San Diego, CA)
- …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...of care analysis to determine efficiency, the efficacy of case management system as well as any… more