- Dignity Health (Woodland, CA)
- …the RN Care Coordinator to coordinate care plans based on the utilization review activities performed by the RN Care Coordinator with compliance of ... duties as assigned. The care team program improves the quality of care and clinical outcomes for members with complex care needs by coordinating care… more
- Ventura County (Ventura, CA)
- …that establish, expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities ... Type Full-Time Temporary Job Number 0343HCA-25AB (VM) Department Health Care Agency Division Ventura County Medical Center and/or Santa...such as utilization review , monitoring and evaluation procedures, and… more
- Sutter Health (San Francisco, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care , and observation status. + Some ... Overview:** The RN Case Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute … more
- HCA Healthcare (Riverside, CA)
- …Nurse (RN) with current California license required, Case Management Certification or utilization review preferred + Associate's Degree minimum required + ... that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization . Requirements: + Registered… more
- CVS Health (Sacramento, CA)
- …CISM experience. + Human Resource and/or Supervisory experience. + Case management, Utilization Review , or Utilization Management background preferred. ... concerns. Coordinates critical incident and disruptive event response. Provides member clinical assessments and triage into care . Performs case management… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- …patients to other services. This position will assist in increasing continuity of care and provider utilization metrics. This is an on-call position, which ... cancelled appointments to schedule patients in order to ensure everyone receives access to care . + Panel Management: Review all upcoming and past appointments to… more
- Emanate Health (West Covina, CA)
- … clinical consults according to pharmacy guidelines and conducting ongoing drug utilization review to promote effective, safe and efficient use of ... your Workday account to apply** Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at… more
- Cardinal Health (Sacramento, CA)
- **_What Specialty Networks contributes to Cardinal Health_** Specialty Networks creates clinical & economic value for independent specialty providers & partners in ... patient outcomes by getting each patient to the right care at the right time. Specialty Networks works with...Networks in creating value to the members in their clinical , operational, and economical goals. This individual will be… more
- Cedars-Sinai (Santa Monica, CA)
- …lead for the Medical Assistants in the office. This position supports the physician and clinical staff in the delivery of health care by performing a variety of ... on the approved standard work. This position also assists with providing a review of clinical and administrative skills, assessing the workflow and monitoring… more
- HCA Healthcare (Riverside, CA)
- …Nurse (RN) with current California license required, Case Management Certification or utilization review preferred + Associate's Degree minimum required + ... that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization . Requirements: + Registered… more