- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …manner. + Concurrent Stay Reviews: Conduct concurrent and extended stay reviews for both managed care cases and Kepro counites in a timely manner to ensure ... $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...reimbursement + Two or more years' experience working in managed care environment + Ability to apply… more
- Dignity Health (Santa Maria, CA)
- …company policy. CRE II Basic knowledge of the healthcare industry, Medicare, managed care , insurance reimbursement and accounting practices. Knowledge of ... support the branch's business plan. This position will work with the Director , Business Development; Regional Vice President, Market Development; or Vice President,… more
- University of Southern California (Los Angeles, CA)
- …and documents avoidable delays in the M drive. * Maintains awareness of current managed care contract requirements. * Participates in appeal process. * Performs ... In collaboration with the interdisciplinary team, provides care coordination services evaluating options and services required to meet an individual's health care… more
- Datavant (Sacramento, CA)
- …payor guidelines. * **What you will bring to the table:** + Two (2) years managed care experience in UM/CM/CDI Department preferred + Knowledge of CMS, State ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...author appeal letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted… more
- CommonSpirit Health (Rancho Cordova, CA)
- …supervisory role highly preferred + Experience in Utilization Management, Case Management or Care Coordination, Managed Care is preferred **Where You'll ... quality assurance reviews of work performed and communicating with department manager and director the outcomes of the review and any identified issues or barriers.… more
- Actalent (Sacramento, CA)
- …medical record (EMR) systems + Previous experience with IPA, MSO, or delegated managed care environments preferred. + Working knowledge of EZ-CAP, EZ-Net, ... reviews + Escalate complex or ambiguous cases to the Vivant Health Medical Director or Physician Reviewer + Ensure complete, accurate, and compliant documentation in… more
- Takeda Pharmaceuticals (CA)
- …of the PI Sales Team, you will report to the Sr. Regional Business Director . **How you will contribute:** + Achieve sales quotas through driving new patient starts, ... healthcare professionals (Allergy/Immunology, Pulmonology, Infectious Disease, select Internal Medicine/Primary Care ). Educate and inform the HCPs on Takeda brands… more
- CommonSpirit Health (Rancho Cordova, CA)
- …or including supervisory role + Experience in Utilization Management, Case Management or Care Coordination, Managed Care is preferred **Where You'll Work** ... quality assurance reviews of work performed and communicating with department manager and director the outcomes of the review and any identified issues or barriers.… more
- Cayuse Holdings (Sacramento, CA)
- …work experience. MBA is a plus. + 7+ years of experience in network operations or managed services, with at least 3 years in a leadership role. + Proven track record ... business development, or pre-sales engineering related to IT services or managed services is essential. + Experience managing global or geographically dispersed… more
- University of Southern California (Los Angeles, CA)
- …through vision and purpose, has academic credentials of merit, has effectively managed people around short and long-term objectives, understands the business of ... are all necessary skills. Responsibilities The candidate will balance a clinical patient care practice that spans the wide variety of care settings and… more