- Prime Healthcare (Chula Vista, CA)
- …assist with development and implementations of discharge plans. Assists with case management referrals and authorizations. Maintains and coordinates Medicaid state ... submission forms for presentation to on-site reviewer and files them accordingly or as per facility's...qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both managed care… more
- Ventura County (Ventura, CA)
- …direction, the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ensure ... of: + Principles, practices, techniques and methods used in Utilization review /management, case management, wellness and prevention or disease management;… more
- Cedars-Sinai (Beverly Hills, CA)
- …nurse practitioner and case manager assigned to the SNF's for continued review and follow up. + Authorizes all appropriate services based upon covered benefits ... Little More About What You Will be Doing** The Case Manager is responsible for the case ...needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and… more
- County of El Dorado (Placerville, CA)
- …Assurance analysis in a Social Services program including, but not limited to peer review , case review , program monitoring and/or data sampling. Include in ... and families, for adults; perform assessments and eligibility determinations involving individualized case plans and application of casework methods; may serve as a… more
- US Marine Corps (Bridgeport, CA)
- …Participate in and provide input to the PSB-CY multi-disciplinary team and attend monthly case review meetings. Maintain case records and track statistical ... assessment, evidence-based and informed interventions, service planning, and clinical case management services. Comprehensive non-medical counseling services consists of… more
- Elevance Health (Los Angeles, CA)
- …to members and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology ... regimens and supportive care. + Perform physician-level case review , following initial nurse review , of chemotherapy regimens. + Determine medical necessity… more
- Mendocino County Sheriff's Office (CA)
- …They work independently to support families through assessment, service linkage, ongoing case management, and reunification efforts. Earn your AA, BSW, or MSW with ... in order to identify and provide social services. Performs case studies and evaluates individual and family case...Reasonable notice is required to allow adequate time for review and evaluation of your request. Special Requirements: Employment… more
- US Marine Corps (Oceanside, CA)
- …Participate in and provide input to the PSB-CY multi-disciplinary team and attend monthly case review meetings. Maintain case records and track statistical ... assessment, evidence-based and informed interventions, service planning, and clinical case management services. Comprehensive non-medical counseling services consists of… more
- City and County of San Francisco (San Francisco, CA)
- …and responds to reports of program misuse. + Reviews and evaluates intakes by case review , case conferences, and individual conferences to ensure that ... Adults Protective Services, home delivered meals, In Home Supportive Services, case management, Community Living Fund, Enhanced Care Management and Information,… more
- LA Care Health Plan (Los Angeles, CA)
- …to complete reviews and determinations within required turnaround times specific to the case type. Identifies requests needing medical director review or input ... Management Medical Director, on requests where determination requires extended review . Collaborates with the inpatient care team for facilitation/coordination of… more