- Providence (Anaheim, CA)
- …for additional information. + 1 year of experience working with physicians in a managed care /IPA, Medical group, health plan or MSO environment with Provider ... **Description** Under the supervision of the Director , the Provider Relations Representative functions as a...Bachelor's Degree in Healthcare Management. + 2 years of Managed care Provider Relations experience. **Why Join… more
- Dignity Health (Bakersfield, CA)
- …- Masters degree preferred. - 5 years experience with background in a managed care facility, IPA or health plan preferred. **Overview** The purpose ... The Manager, Network Strategy and Contracting reports to the Director of Provider Contracting. Key areas of oversight include...pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to… 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
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …of California Mental Health Laws. + Two or more years' experience working in managed care environment + Ability to apply and interpret admission and continued ... Santa Rosa and Northern California mental health system of care . Conveniently located in the North Bay, this hospital...Holds Coordinator Pay Range: $29.50-$37.24 Per Hour REPORTS TO: Director of Social Services DESCRIPTION OF POSITION: Track and… more
- Cedars-Sinai (Beverly Hills, CA)
- …resources and social supports required. One (1) year of utilization management or managed care experience preferred. **About Us** Cedars-Sinai is a leader in ... Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the coordinator assists in… more
- CommonSpirit Health (Rancho Cordova, CA)
- …or including supervisory role + Experience in Utilization Management, Case Management or Care Coordination, Managed Care is preferred **Overview** Inspired ... 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
- Dignity Health (Bakersfield, CA)
- …care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals ... monitor and assure the appropriateness and medical necessity of care as it relates to quality, continuity and cost...to make a determination and/or coordinate with the Medical Director as needed. - Responsible to coordinate with contracting… 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
- CommonSpirit Health (Camarillo, CA)
- …include any combination of the following responsibilities: + Manages single acute care facility totaling approximately 500,000 square feet and less than 250 licensed ... Health's Mission, Philosophy and Core Values. Reporting Relationships Reports directly to Director , Facility Mgmt. or Division Director , Facility Mgmt. within… more
- Sutter Health (San Francisco, CA)
- …knowledge base of health care delivery and case management within a managed care environment. + Comprehensive knowledge of Utilization Review, levels of ... The RN Case Manager reports to either the Supervisor or Manager or Director of Care Coordination in each facility. The RN Case Manager has frequent contact with… more
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