- Amergis (Orange, CA)
- … Case Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more
- Elevance Health (Walnut Creek, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
- Genesis Healthcare (Elk Grove, CA)
- …clinical management of the rehabilitation department, including oversight related to case management, quality improvement, care planning, clinical utilization , ... or coordinating the timely completion of the annual merit review for therapy staff. 6. Assists in management of...of therapy staff. 7. Assists in daily staffing and utilization in cooperation with input from treating therapists, consideration… more
- Elevance Health (CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... for clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss … more
- Griffith Company (Brea, CA)
- …methods and sequence of operations. + Coordinate manpower and equipment utilization . + Assist project manager in conducting effective ... Review job costs and budget controls with project manager /foreman. + Monitor processing of timesheet and extra work...to candidates outside of the local area on a case -by- case basis. Visit us at: www.griffithcompany.net. Griffith… more
- Sharp HealthCare (San Diego, CA)
- …response to therapeutic interventions via collateral calls, conjoint therapy sessions, utilization review process, and/or referrals and revises care plan ... with the interdisciplinary treatment team, coordinates patient care and provides case management for assigned patients. **Required Qualifications** + Master's Degree… more
- CommonSpirit Health (Rancho Cordova, CA)
- …for completing quality assurance reviews of work performed and communicating with department manager and director the outcomes of the review and any identified ... leading up to or including supervisory role highly preferred + Experience in Utilization Management, Case Management or Care Coordination, Managed Care is… more
- CommonSpirit Health (Rancho Cordova, CA)
- …for completing quality assurance reviews of work performed and communicating with department manager and director the outcomes of the review and any identified ... responsibilities leading up to or including supervisory role + Experience in Utilization Management, Case Management or Care Coordination, Managed Care is… more
- City and County of San Francisco (San Francisco, CA)
- …assistance and engage with a wide cross-sector of community partners. + Skilled in case management. Knowledgeable in the utilization of case management ... and fines, and management of follow up communications and case resolution efforts. + Assist in the administration and...the city's online debris tracking system, Green Halo. + Review Material Reduction and Recovery Plans (MRRPs) to ensure… more
- Cedars-Sinai (Los Angeles, CA)
- …required Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge of ... under the general direction of the HID CDI/Core Measures Supervisor or Manager , with responsibility for improving the overall quality and completeness of clinical… more