- Highmark Health (Sacramento, CA)
- …drug utilization reports, and write drug monographs for Committee review to develop the Organization's Drug formulary and/OR provide recommendations for NDC ... improvements to maximize overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Requirements Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), … more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team ... or Management. + Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as needed. + Assists the Case/Care Managers in… more
- Cedars-Sinai (Beverly Hills, CA)
- …You Will be Doing** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team ... or Management. + Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as necessary. + Assists the Case/Care Managers in… 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 ... in-patient Care Management program that includes initial and concurrent review ; case management/discharge planning activities. Responsible for operational planning… more
- Hospice Of San Joaquin (Stockton, CA)
- …about the Hospice philosophy and Hospice's services. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW : Ensures compliance with the program plan, assuring ... team plan of care, under the supervision of the Director of Home Care Services and the direction of... of resources. + Participates in Quality Assessment/Improvement and Utilization Review activities as requested by administration.… more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse ... of defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for physician … more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse ... of defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for physician … more
- Fujifilm (Sacramento, CA)
- …improve how we report on various activities. The role reports to the Director , Marketing & Communication in the Endoscopy division. **Company Overview** At FUJIFILM ... identifying activities, sponsorships, and equipment needed to ensure success. + Review and consideration of event participation levels and requirements, involving… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- …+ Preventative and Chronic Disease Management. + Risk adjustment, cost, utilization , and value-based performance. + Access, including for those assigned but ... and optimize access, provider productivity, panel sizes, appointment availability, and utilization of visit types (in-person, telehealth, co-visits, group visits). +… more