- Elevance Health (Walnut Creek, CA)
- …preferred. + Extensive spine surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. + **Orthopedic ... Medical Director ** **Orthopedic Spine Surgery** **Carelon Medical Benefit Management ** **Schedule: 10:30 AM-7 PM Central** **Virtual:** This role enables… more
- CommonSpirit Health (Rancho Cordova, CA)
- …within multiple markets in a region. Oversees the centralized functions of Utilization Management Services, including but not limited to medical necessity ... the Savramento Area.** **Job Summary / Purpose** The Market Director of Acute Care Coordination is at the forefront...care coordination staff within the assigned markets. + **Comprehensive Management of Corporate Case Management … more
- CVS Health (Sacramento, CA)
- …well as sales and account management . Duties include support for - case management , clinical content research & development, chronic condition management ... experience in health care delivery (clinical practice) Experience in managed care, care management , utilization management , quality management , or… more
- Dignity Health (Grass Valley, CA)
- …of three (3) years progressive supervisory or management experience in a Case Management , Care Coordination or Utilization Management department ... nurse) or LCSW (if a Social Worker) We prefer candidates with a Case Management national certification. **Overview** Dignity Health Sierra Nevada Memorial… more
- Highmark Health (Sacramento, CA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
- Veterans Affairs, Veterans Health Administration (Long Beach, CA)
- Summary The Associate Director for Patient Care Services (Nurse Executive) provides direct oversight of Nursing, Social Work, Chaplain, Pharmacy, Sterile Processing, ... decision-making on behalf of the public and staff. Develops resources utilization strategies to improve organizational performance. Mentors others in executive… more
- Global Foundries (Santa Clara, CA)
- …strengthen external relationships with customers and technology partners. * Business Case Development: Plan, develop, and analyze business cases, including R&D and ... capital investments, asset utilization , and cost elements, to inform pricing and go-to-market...elements, to inform pricing and go-to-market strategies. * Program Management : Define and implement effective systems to manage and… more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary ... and receives clinical supervision as needed from the Medical Director of Care Management . The position is...care with internal LA Care departments such as Care Management (CM), Utilization Management (UM),… more
- North Marin Community Services (Novato, CA)
- …up to 2% retirement employer match, and childcare discount. With the guidance of the Director of Case Management and Housing, the CSS Manager provides ... a focus on continuous quality improvement. + Ensure effective utilization of technology, including Apricot, HMIS, and other data...county, and collaborative meetings as needed. + Work with Director of Case Management and… more
- HCA Healthcare (Riverside, CA)
- …care issues. Offers clinical support for appeals and denials process, discharge planning, case management , and utilization review/ management + You ... will consult with facility-level staff regarding delegated utilization management and disease management ...the denial and appeals process, as requested by the Case Management Department and Patient Accounting Services… more