- Elevance Health (Walnut Creek, CA)
- …clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical...is filing a role required by a State agency. ** Preferred Skills, Capabilities and Experiences:** + Child and Adolescent… more
- Elevance Health (Los Angeles, CA)
- …with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... for posting. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical...is filing a role required by a State agency.*_ ** Preferred Skills, Capabilities and Experiences:** + Experience caring for… more
- Travelers Insurance Company (Irvine, CA)
- …with insured based on application of policy information to facts or allegations of each case . + Consults with Manager on use of Claim Coverage Counsel as needed. ... **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By...**What Will Our Ideal Candidate Have?** + Bachelors Degree preferred . + 5 years equivalent business experience preferred… more
- Elevance Health (CA)
- …and/or medical policies. May collaborate with healthcare providers. Focuses on relatively complex case types that do not require the training or skill of a ... required if this individual is providing services in multiple states. ** Preferred Skills, Capabilities, and Experiences:** + Utilization Management experience is… more
- Obran Cooperative (Pleasanton, CA)
- …development and implements prior to discharge of the patient. + Acts as Case Manager when assigned by Clinical Supervisor/Nursing Supervisor and assumes ... needs of individuals and families within their homes and communities . Apollo is an Obran Cooperative Company. Obran Health...in good working order. + The following qualifications are preferred , but not required: + One (1) to two… more
- Amergis (Orange, CA)
- …/ Week Amergis Healthcare is seeking a highly motivated an experienced LMFT/LCSW Medical Case Manager to help support a health insurance agency! The Medical ... Case Manager (BHI Utilization Management) will be...such as those listed above may also be qualifying. Preferred Qualifications: + Utilization management reviewer experience. + Managed… more
- LA Care Health Plan (Los Angeles, CA)
- …access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that ... Reality and Virtual Reality, job aids, participant and facilitator guides, case studies, infographics, and other related deliverables. Designs storyboards and… more
- Dignity Health (Woodland, CA)
- …criteria in performing review and documents appropriate sections. - Preps case thoroughly, concisely and clearly for physician review. Researches EMR, criteria, ... medical policy and past history of member to detail case cleanly for MD. - Communicates findings to physician...Reliability audits as directed by the UM Supervisor or Manager . - Performs audits of medical records as requested… more
- VNA Health (Santa Barbara, CA)
- …productivity standards set by the agency. + Performs other duties as assigned by the Case Manager and Hospice or Home Health Manager . + Actively participates ... real difference in the lives of our patients and communities , driving positive change in healthcare. Join us in...PT, MSW, ST, Dietitian or Hospice or Home Health Manager . + Uses equipment and supplies effectively and efficiently.… more
- San Diego Youth Services (Spring Valley, CA)
- …Valley. This is a full-time & non-exempt position reporting to the PEI Program Manager . San Diego Youth Services: Who we are San Diego Youth Services has helped ... youth overcome trauma and challenges that put them at risk, including case management, counseling, mental health treatment and educational support and resources.… more