- Sevita (Redding, CA)
- …all every day. Join us today, and experience a career well lived. **Regional Director ** **Annual Salary: $93,000** Have you been looking for a fantastic role to ... quality. + Execute regional core growth strategy to increase census, maximize utilization and occupancy percentages; respond to local requests for proposals to… 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
- 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
- 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
- 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
- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- HCA Healthcare (Riverside, CA)
- …care issues. Offers clinical support for appeals and denials process, discharge planning, case management , and utilization review / management + You will ... of quality and cost improvement, and develops systems to review utilization of resources and objectively measure...consult with facility-level staff regarding delegated utilization management and disease management … more