- Molina Healthcare (Los Angeles, CA)
- …Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of InterQual / ... California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_3-12 DAY SHIFT 7:30AM - 08:30PM...assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long… more
- Evolent (Sacramento, CA)
- …Provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Ventura County (Ventura, CA)
- …limited to the following: + Develops and revises policies and procedures or clinical practice guidelines to optimize drug utilization and medication safety while ... + Develops and presents therapeutic class review for medical staff review to include utilization , financial analysis, contract compliance, safety and… more
- Sharp HealthCare (San Diego, CA)
- …when not in use.Is knowledgeable of current laws and regulations regarding Utilization Review and Discharge Planning.Morning arrival time insures orderly ... + Data collectionParticipates in data and statistics collection as requested by Utilization Review , Service Line and Quality Improvement Committees. + Denial… 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 ... the health of our patients and our communities by providing extraordinary care . DEFINITION: Provides specialized clinical pharmacy services in the delivery… more
- CVS Health (Sacramento, CA)
- …of utilization management services for assigned area + Implements clinical policies & procedures in accordance with applicable regulatory and accreditation ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...Manager is accountable to support the day to day clinical and business operations of the team. This position… more
- Sutter Health (Santa Rosa, CA)
- …SPMF-Sutter Pacific Medical Foundation - North **Position Overview:** Delivers pharmaceutical care through the provision of patient-centered clinical service, ... dispensing of chemotherapy, biotherapy, and other infusion drugs. Provide direct patient care , patient education, and actively participating in clinical decision… more
- Stanford University (Stanford, CA)
- …and intensive end-of-life care , and improves hospice and palliative care utilization . Additionally, the study will assess patient, caregiver, clinician, ... to the coordination of health services clinical studies focusing on improving clinical cancer care delivery under the supervision of Dr. Manali Patel's… more
- Sharp HealthCare (San Diego, CA)
- …therapeutic interventions via collateral calls, conjoint therapy sessions, utilization review process, and/or referrals and revises care plan as necessary. ... patient assessments (psychosocial, SI/HI, safety, DC planning) as related to the clinical services provided.Formulates plan of care based on clinical… more
- Tiburcio Vasquez Health Center (San Leandro, CA)
- …evidence-based, and patient-centered pharmaceutical care within an ambulatory care setting. The Clinical Pharmacist collaborates with the interdisciplinary ... Under the direction of the Chief Medical Officer, the Clinical Pharmacist plays an essential role in delivering safe,...well-being of our community by providing accessible, high quality care by integrating primary care , dental … more