- Highmark Health (Sacramento, CA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Vail Resorts (CA)
- …is filled (whichever is first). **Jo** **b Summary:** The Senior Director of Strategic Mountain Planning is responsible for leading long-range, multi-disciplinary ... related to terrain expansion, lift infrastructure, skier circulation, capacity management , and guest experience. Working cross-functionally with operations, finance,… more
- Travelers Insurance Company (Sacramento, CA)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically… more
- Centene Corporation (Sacramento, CA)
- …and if identified, refer to the Medical Director or provider for review and verification + Consults with senior management and healthcare providers, as ... Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + For Health… more
- LA Care Health Plan (Los Angeles, CA)
- …in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer: The expected pay range ... the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and… 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 ... members of Utilization Management , Patient and Provider Services, Claims...Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as needed. + Assists… more
- Cedars-Sinai (Beverly Hills, CA)
- …be Doing** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team members ... of Utilization Management , Patient and Provider Services, Claims...Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as necessary. + Assists… more
- Dignity Health (Rancho Cordova, CA)
- …working knowledge of Utilization Management Working knowledge of the Utilization Management review processes, and regulatory requirements. Must have ... home.** **Position Summary:** Under the guidance and supervision of the department Manager/ Director the Supervisor of Utilization Management is responsible… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as… more
- Lompoc Valley Medical Center (Lompoc, CA)
- …nursing degree preferred. + Experience: A minimum of two years of clinical experience in Utilization Review or Case Management is preferred. + Per Diem ... + Reports to the Director of Case Management + Plan, organize and deliver utilization ...required. Must demonstrate knowledge of current utilization management principles, third party payor review requirements,… more