- Sutter Health (Emeryville, CA)
- …of transitions-of- care coordination best practices. + Proficiency in utilization management processes: authorizations, concurrent review , and medical ... Plan Operations, is a senior executive responsible for providing strategic and clinical leadership across Sutter's value-based care initiatives, Sutter Health… more
- Stanford Health Care (Palo Alto, CA)
- …committees. + Ensures all operational mandates and initiatives are completed (eg, C-I- CARE rounds). + Administration: + Review and participate in financial ... and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond... methods to identify and implement innovations in patient care and/or participating in research, clinical investigatory… more
- LA Care Health Plan (Los Angeles, CA)
- Authorization Technician II (12 Month Assignment) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... Range: $47,840.00 (Min.) - $57,062.00 (Mid.) - $68,474.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of… more
- HCA Healthcare (Riverside, CA)
- …a data-driven environment of quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care ... support for appeals and denials process, discharge planning, case management, and utilization review /management + You will consult with facility-level staff… more
- Magellan Health Services (San Diego, CA)
- …an appropriate and effective person-centered care plan, member education and care management. Conducts initial and concurrent review for prior authorization ... of assigned care support teams. Experience with Care Management flows. Knowledge of utilization management...Preferred License and Certifications - Required LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT… more
- Sutter Health (Tracy, CA)
- …and professional staff is competent and sufficient to provide direct and indirect patient care and clinical services to the patient population of these units. ... units. The role is also a resource person for decision-making concerning patient care services, non- clinical services and ensures that hospital policies and… more
- STG International (Corona, CA)
- …safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health ... as the point of entry into the VA health care system. *Participate in the orientation of clinical...Quality Performance Improvement Team (QPIT) strategic initiatives. *Participate in review and improvement of clinical success in… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …assigned panel when Veteran care indicates a need for such. Medical care is delivered in accordance with current clinical practice guidelines with attention ... to prevention via utilization of evidence-based clinical decision-making tools. In addition to the provision of high-quality medical care , PACT Physicians… more
- Novo Nordisk (Long Beach, CA)
- …guidelines, chronic care models, protocols, etc. to engage HCPs in clinical conversations to appreciate how they manage patients with diabetes and where they ... Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious...Representative also assists their target physicians with their local clinical and educational initiatives by coordinating company resources (eg,… more
- Stanford Health Care (Palo Alto, CA)
- …strategic direction and operational leadership related to psychosocial needs assessments, clinical care coordination, SDOH support programs and community ... strategy to execution through the implementation of systems, processes, and outcomes of clinical care teams and programs designed to address the clinical… more