- Evolent (Sacramento, CA)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to ... on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Dignity Health (Redwood City, CA)
- …effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more
- Evolent (Sacramento, CA)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical...needed for new hires to educate and train on Utilization management system and Field Medical Director… more
- Sutter Health (Emeryville, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... A broad knowledge base of health care delivery and case management within a managed care environment.... within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Utilization management experience in a medical management review organization, such as Medicare Advantage,... Case managers or Care managers on complex case management , including familiarity with social determinants… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Utilization management experience in a medical management review organization, such as Medicare Advantage,... Case managers or Care managers on complex case management , including familiarity with social determinants… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Utilization management experience in a medical management review organization, such as Medicare Advantage,... Case managers or Care managers on complex case management , including familiarity with social determinants… more
- Dignity Health (Los Angeles, CA)
- …effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more
- Dignity Health (Long Beach, CA)
- …effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs ... will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers...acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu… more
- Dignity Health (Glendale, CA)
- …effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more