- The County of Los Angeles (Los Angeles, CA)
- …and their families. + Participates with hospital administration, medical administration, clinical care teams, and professional staff of other disciplines ... performance improvement related to program/service delivery in accordance with regulatory health care agency standards. + Represents the clinical social work… more
- Ventura County (Ventura, CA)
- …and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + Direct patient care medical practice experience + ... communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization ... + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review … more
- Evolent (Sacramento, CA)
- …you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director, ... when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the… more
- Stanford Health Care (Palo Alto, CA)
- …+ ICU/ED and Academic Medical Center experience preferred. + Case management, utilization review and/or direct provider interaction experience, preferred. + ... (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** The Clinical ...Health Care job.** **A Brief Overview** The Clinical Documentation Integrity (CDI) Service Line Outcomes Lead is… more
- CenterWell (San Diego, CA)
- … of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts ... caring community and help us put health first** The Clinical Manager coordinates and oversees all direct care...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Sharp HealthCare (San Diego, CA)
- …decisive manner. + Able to manage difficult peer situations arising from medical care review . + Appreciation of cultural diversity and sensitivity towards target ... selected utilization /cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations for updating current polices to meet… more
- Stanford Health Care (Palo Alto, CA)
- …requested clinical and psychosocial information to assure reimbursement. + Utilization Review -- Reviews prospectively, concurrently and retrospectively all ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
- Sharp HealthCare (San Diego, CA)
- …decisive manner. + Able to manage difficult peer situations arising from medical care review . + Appreciation of cultural diversity and sensitivity towards target ... accountable for and provides professional leadership and direction to the utilization /cost management and clinical quality management functions. Works… more
- The County of Los Angeles (Los Angeles, CA)
- … Units (MICU, SICU, NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care , Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug ... Units (MICU, SICU, NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care , Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug… more
- Elevance Health (Costa Mesa, CA)
- …or case management experience and requires a minimum of 2 years clinical , utilization review , or managed care experience; or any combination of education ... PST, this position includes weekends. The Med Mgmt Nurse is responsible for review of the most complex or challenging cases that require nursing judgment, critical… more