- Zurich NA (Sacramento, CA)
- …position, offering the flexibility of a home - based office. As the AVP of Utilization Review & Pharmacy, you will lead and direct a team of Utilization ... AVP, Utilization Review & Pharmacy 123092 Zurich...provided range to apply as they will be considered based on their experience, skills, and education. The compensation… more
- Stanford Health Care (Palo Alto, CA)
- …- 3+ years of experience in case management - 3+ years of experience in utilization review Why work at Stanford Medicine | Stanford Health Care (SHC)? - ... and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. +… more
- Evolent (Sacramento, CA)
- …mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Utilization … more
- Humana (Sacramento, CA)
- …is responsible for overseeing and managing risks associated with Medicaid utilization management (UM) programs to ensure compliance with MHPAEA regulations. This ... stakeholders to ensure audit readiness. Humana is seeking a seasoned expert in Utilization Management to join the UM Risk Management team and help support Medicaid… more
- Elevance Health (Walnut Creek, CA)
- …personalized support throughout the consumer's treatment journey._ **Title** : Utilization Management Representative II **Location:** virtual position. This role ... Monday - Friday, 8:30am - 5pm PST. May need to work weekends/holidays based on business need. **Build the Possibilities. Make an Extraordinary Impact.** The **… more
- Veterans Affairs, Veterans Health Administration (Martinez, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Physician Employment Contract and no significant restriction on moonlighting The Home Care Coordination Teams provide intensive interdisciplinary support for frail… more
- Ventura County (Ventura, CA)
- …+ Experience with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + At ... reasons many of the 802,983 residents call Ventura County " home ." Ventura has a diverse economic base from tourism...care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review … more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- Summary The Patient Flow Utilization Management/ Utilization Review Consultant RN functions with advanced knowledge and skills to provide clinical ... with a collaborative, inter-disciplinary practice setting. Responsibilities The Patient Flow Utilization Management/ Utilization Review Consultant RN is… more
- Sharp HealthCare (San Diego, CA)
- …outcomes while maintaining quality care standards.Complies with payer guidelines on utilization review process to promote optimal reimbursement.Identifies and ... Understanding of performance improvements and research methodologies. + Basic knowledge of utilization review criteria and health care finances. + Excellent… more
- Ventura County (Ventura, CA)
- …that establish, expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities ... Field Based Psychiatric Technician - Behavioral Health (Regular &...+ Travels to meet and engage with patients at home and in the community to build trust and...such as utilization review , monitoring and evaluation procedures, and… more