- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $31.50-37.50 Per Hour RN/LCSW/LMFT/LPCC ... $54.00-64.00 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of multi-disciplinary...in a clear, concise, organized and timely manner. + Medical Necessity: Attend Treatment Team on a daily basis… more
- Robert Half Legal (Oakland, CA)
- Description We are seeking a California-barred Document Review Attorney for a fully remote opportunity supporting litigation and compliance projects. This role is ... East Bay area for occasional in-person meetings or onboarding. Responsibilities + Review and analyze large volumes of documents for relevance, privilege, and… more
- City and County of San Francisco (San Francisco, CA)
- …is looking for an experienced and motivated civil litigator to join its Complex & Affirmative Litigation Team. About the Office The San Francisco City Attorney's ... the City Attorney's Office please visit: https://www.sfcityattorney.org/ (about:blank) About the Complex & Affirmative Litigation Team The team is a collaborative,… more
- Ventura County (Ventura, CA)
- …the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ensure that ... a case manager in a health plan case managing complex cases. + Demonstrated experience...+ Principles, practices, techniques and methods used in Utilization review /management, case management, wellness and prevention or… more
- Actalent (Sacramento, CA)
- …rounds 2-3 days per week, telephonic review and participate in interdisciplinary case reviews + Escalate complex or ambiguous cases to the Vivant Health ... Medical Director or Physician Reviewer + Ensure complete, accurate, and compliant documentation in...+ At least 1 year of experience in utilization review , case management, or hospital discharge planning… more
- Humana (Sacramento, CA)
- …team and healthcare organization. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, ... quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will...with Case managers or Care managers on complex case management, including familiarity with social… more
- CenterWell (Sacramento, CA)
- …knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review ... and use of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management, including familiarity with social determinants of… more
- Humana (Sacramento, CA)
- …knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review ... group practice management. + Utilization management experience in a medical management review organization, such as Medicare...with Case managers or Care managers on complex case management, including familiarity with social… more
- Humana (Sacramento, CA)
- …knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review ... group practice management. + Utilization management experience in a medical management review organization, such as Medicare...with Case managers or Care managers on complex case management, including familiarity with social… more
- Elevance Health (Los Angeles, CA)
- …Rotating Weekends and holidays. The ** Medical Management Nurse** is responsible for review of the most complex or challenging cases that require nursing ... not in line with diagnosis. + Provide consultation to Medical Director on particularly peculiar or complex ...skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has… more