- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical...Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- Prime Healthcare (Inglewood, CA)
- …full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management Team consisting ... and Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure patiens receive… more
- Humana (Sacramento, CA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- Humana (Sacramento, CA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- Ventura County (Ventura, CA)
- …communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance ... Medical Director , Ventura County Health Care Plan Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4924113) Apply Medical Director , Ventura… more
- BrightSpring Health Services (Sacramento, CA)
- …of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review utilization report at least monthly to ensure adequate ... with behavioral and programmatic staff in partnership with the Executive Director . The Director of Nursing is accountable for overseeing the day-to-day clinical… more
- LA Care Health Plan (Los Angeles, CA)
- …admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination requires ... Utilization Management Admissions Liaison RN II Job Category:...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Sharp HealthCare (San Diego, CA)
- …under the direction of the manager of in-patient care management and the Director of Utilization Management. **Required Qualifications** + 3 Years Experience in ... Degree Health care related field **Other Qualification Requirements** + Utilization , Case Management, or Quality Management certification preferred. **Essential… more
- Dignity Health (Rancho Cordova, CA)
- …home.** **Position Summary:** Under the guidance and supervision of the department Manager/ Director the Supervisor of Utilization Management is responsible and ... referral. Fosters the relationship between the Pre-Authorization team and the Medical Director and Physician Reviewers. - Tracks cost savings from activities over… more
- LA Care Health Plan (Los Angeles, CA)
- …information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time ... Authorization Technician II (12 Month Assignment) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full… more