- Prime Healthcare (Inglewood, CA)
- …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization … more
- Lompoc Valley Medical Center (Lompoc, CA)
- …internal equity. Position Summary + Reports to the Director of Case Management + Plan, organize and deliver utilization management activities for BOP ... preferred. + Experience: A minimum of two years of clinical experience in Utilization Review or Case Management is preferred. + Per Diem Positions: Case … more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... and determinations within required turnaround times specific to the case type. Identifies requests needing medical director ...setting. Previous experience to have a strong understanding of Utilization Management / Case Management … more
- LA Care Health Plan (Los Angeles, CA)
- …of work/licensure. The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols, and ... of 7 years of acute/clinical care experience. Minimum of 2 years of experience in Case /Care/ Utilization Management in an acute care or health plan setting.… more
- CVS Health (Sacramento, CA)
- …Review nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed. + Assists management with training new ... feedback, + Actively cross-trains to perform reviews of multiple case types to provide a flexible workforce to meet...3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management… more
- Alameda Health System (Oakland, CA)
- …classification. + Accountable for Patient Care Coordination activities including system-wide Case Management , Care Coordination and Discharge Planning. + Aligns ... Director , Inpatient System Care Management + Oakland, CA +... Case Management with AHS strategic and operational objectives. + Optimizes efficient care … more
- Sharp HealthCare (San Diego, CA)
- …+ Participates in risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs, HEDIS reporting, ... findings in conjunction with the Quality Improvement Director . + Assists in POS/PPO Case Management and high-cost review with CMO and Claims management … more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team ... members of Utilization Management , Patient and Provider Services, Claims...and beyond. **Req ID** : 11487 **Working Title** : Case Management Coordinator - Inpatient Specialty Program… more
- Cedars-Sinai (Beverly Hills, CA)
- …**A Little More About What You Will be Doing** The Case Management Coordinator provides support to the utilization review process. The coordinator works ... collaboratively with all team members of Utilization Management , Patient and Provider Services, Claims...also preferred. **Req ID** : 10884 **Working Title** : Case Management Coordinator (Hybrid) - MNS Ambulatory… more
- Sharp HealthCare (San Diego, CA)
- …performance-planning, competency and individual development planning process.Maintain current knowledge of case management , utilization management , and ... Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Master's Degree; Bachelor's Degree in Nursing… more