- Provider Solutions & Development (Torrance, CA)
- Providence Little Company of Mary is seeking a Physician Advisor/ UM Medical Director to join a strong leadership team promoting high-value care in Torrance, ... relationships between the medical center and its physicians to improve clinical quality , resource utilization and increase value while maintaining and improving our… more
- Provider Solutions & Development (Mission Hills, CA)
- Providence Holy Cross Medical Center is seeking a Physician Advisor/ UM Medical Director to join a strong leadership team promoting high-value care in Mission ... between the medical center and its physicians to improve clinical quality , resource utilization and increase value while maintaining and improving mission… more
- Dignity Health (Bakersfield, CA)
- …authorization requests, gathering necessary information, and escalating to the Medical Director when needed. - Compliance & Accuracy: Meeting turnaround times and ... and collaborating with internal departments to coordinate patient care. - Quality & Cost-Effectiveness: Adhering strictly to utilization management policies to… more
- Sharp HealthCare (San Diego, CA)
- …discharge or services, readmissions to acute or visit to the Emergency Department.Informs Director , QI/ UM of any quality issues.Attends hospitalists rounds, ... SRS primary care physician, and ancillary staff to ensure cost effective quality service throughout the continuum of care. **Required Qualifications** + Other :… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 + ... time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- Molina Healthcare (CA)
- …ability to learn new programs . Preferred Qualifications * Experience with utilization/ quality program management. * Managed care experience. * Peer review ... the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care. Experience conducting Medi-cal reviews Essential… more
- LA Care Health Plan (Los Angeles, CA)
- …cost cases and reports are maintained and referred to the Physician Advisor/ UM Director . Document in platform/system of record. Utilize designated software ... Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and...and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for… more
- Sharp HealthCare (San Diego, CA)
- …support of program initiatives.Lead team members to facilitate and coordinate quality healthcare services and delivery of goods and services to meet a member's ... to Health Services teams.Attends and actively participates in department/team process/ quality improvement activities. + Program Improvement Maintains ongoing… more
- University of Southern California (Alhambra, CA)
- …services required to meet an individual's health care needs to promote cost-effective, quality outcomes. Serves as a consultant to members of the health care team ... integrates the functions of complex case management, utilization management, quality management, discharge planning assessment, and coordination of post-hospital… more
- Cedars-Sinai (Beverly Hills, CA)
- …Research Corporation's Consumer Choice Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We were also awarded the Advisory Board ... discharge from various care settings. In collaboration with the Inpatient Specialty Program (ISP) hospitalists, the RN Care Coordinator will assist patients from the… more