- Molina Healthcare (San Bernardino, CA)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Horizon Services, Inc. (Hayward, CA)
- …of front-line support and milieu staff to ensure full census and efficient utilization management at assigned program(s). Engages in marketing, client retention, ... JOB TITLE: Associate Director of Outpatient & Prevention Program Operations LOCATION:...youth prevention, youth and adult outpatient, sobering programs, withdrawal management , and co-occurring capable residential programs to support the… more
- Sevita (Hayward, CA)
- …us all every day. Join us today, and experience a career well lived. **Program Management - Program Director IDD Services Host Home** **Salary - $68,640 per ... to run a thriving Host Home program? As Program Director , you will be responsible for overseeing all services...manage census, maintain occupancy, improve daily attendance, and/or maximize utilization + Financial Management + When applicable,… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Select Medical (San Diego, CA)
- …, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as ... right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Humana (Sacramento, CA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , or similar activities **Preferred ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience… more
- Sharp HealthCare (San Diego, CA)
- …experience in area of specialty. + Previous clinical experience with cancer care, case management or patient teaching. + Experience facilitating the design, ... outcomes.Utilize data in the evaluation and improvements of the cancer care and Case Management Program.Report program progress and effectiveness on an annual… more
- Elevance Health (Los Angeles, CA)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... **Behavioral Health Medical** ** Director -Psychiatrist** **Appeals** **Location:** This role enables associates to...aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- UCLA Health (Los Angeles, CA)
- …of experience working managed care + Knowledge of Medicare Advantage experience with utilization management , quality improvement, or case management ... + Contribute to interdisciplinary care team rounds for complex case management . The UCLA Health salary range...required + Minimum of 2 years of experience in Utilization Management + 2 or more years… more
- Elevance Health (Costa Mesa, CA)
- …Operations Associate Medical Director ** **Carelon Medical Benefits Management ** **Radiology Benefit Management / Utilization Review** **Virtual** ... radiology, cardiology and oncology. _ The **Clinical Operations Associate Medical Director ** is responsible for supporting the medical management staff… more