• Medical Director - Sharp Health Plan - Hybrid…

    Sharp HealthCare (San Diego, CA)
    …clinical practice of medicine. + Previous experience as a physician executive in a managed care environment, preferably as an HMO Medical Director. + California ... a system that gives feedback to providers individually and collectively regarding managed care effectiveness of individual providers and networks. + Assists… more
    Sharp HealthCare (08/17/25)
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  • Managing Attorney

    International Rescue Committee (Oakland, CA)
    …collected consistently, managed appropriately and reported timely, using IRC's legal case management database and other relevant case management systems. + ... Justice Accredited Representatives, who are supervised by the Senior Immigration Program Manager . The two teams work closely together. JOB OVERVIEW: The Managing… more
    International Rescue Committee (07/30/25)
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  • Discharge Planner - Utilization Management

    Prime Healthcare (Montclair, CA)
    …Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non- managed care environments.2. Experience in ... the Case Management Department under the direction of the assigned Case Manager /Social Worker assist with development and implementations of discharge plans.… more
    Prime Healthcare (08/15/25)
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  • Discharge Planner II (LVN)

    Prime Healthcare (La Palma, CA)
    …Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non- managed care environments.2. Active state ... in 1972, La Palma Intercommunity Hospital is a 141-bed acute- care community hospital and the only hospital in La... Management Department under the direction of the assigned Case Manager /Social Worker assist with development and… more
    Prime Healthcare (07/24/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …a system that gives feedback to providers individually and collectively regarding managed care effectiveness of individual providers and networks. + Assists ... plans to address issues and improve plan and network managed care performance. + Collaborates with Chief...of all clinical appeals and grievances. Collaborates with Customer Care Manager to identify trends in grievances.… more
    Sharp HealthCare (07/19/25)
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  • Bilingual In-Office Community Engagement…

    Molina Healthcare (San Diego, CA)
    …Customer Service, Medical, Front Office, Office Manager , Community Connector, Non-clinical Case Manager , Care Manager , Community Engagement, Public ... Health, Healthcare, Health Care , Managed Care , MCO, Medicaid, Medicare, HEDIS, CAPHS, equity community health advisor, family advocate, advocacy, health… more
    Molina Healthcare (09/03/25)
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  • Psychiatrist

    Valor Health (Gardena, CA)
    …VA and works with these patients utilizing rules set forth by the VA for co- managed care . + Conducts individual, group, and family and marriage counseling and/or ... the time of each patient visit. + Assists in co- managed care collaboration with non-VA providers, and...collaboration with non-VA providers, and facilities. + Functions as case manager as needed. + Provides patient… more
    Valor Health (06/10/25)
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  • Licensed Vocational Nurse - Hybrid

    Actalent (Sacramento, CA)
    …medical record (EMR) systems + Previous experience with IPA, MSO, or delegated managed care environments preferred. + Working knowledge of EZ-CAP, EZ-Net, ... Health standards + Monitor daily inpatient census for Vivant Health- managed members across contracted hospitals + Support discharge planning...InterQual, and MCG preferred. + Certified Case Manager (CCM), CPUR, or CPHM credential… more
    Actalent (09/04/25)
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  • LVN Home Health

    Dignity Health (Santa Maria, CA)
    …Home Health experience **Special Skills:** + Demonstrates ability to work within a case - managed model of patient- care delivery. + Demonstrates proficient ... changes. **Interacts with Staff** Collaborates, cooperates and coordinates with RN Case Manager /supervisor to assure effective, consistent management of clients.… more
    Dignity Health (08/10/25)
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  • Oncology Sales Specialist (Sacramento Greater…

    J&J Family of Companies (Sacramento, CA)
    …long-term sales potential relevant to percentage of patients treated, patient mix, Managed Care organizations and Specialty Pharmacies, and new protocols or ... is a Field Based role reporting to a District Manager . As the OSS you will: + Fulfill sales...hospital and large account sales, understand complex reimbursement and managed care dynamics with a documented history… more
    J&J Family of Companies (09/04/25)
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