- Prime Healthcare (Chula Vista, CA)
- …Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non- managed care environments. 2. Experience ... the changing needs of our community. Our 291-bed, acute care hospital features the San Diego Spine & Joint... Management Department under the direction of the assigned Case Manager /Social Worker assist with development and… more
- 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
- 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
- CenterWell (Sacramento, CA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... skills, with prior experienceparticipatingin teams focusing on transitions of care , quality management,utilizationmanagement, case management, discharge planning… more
- 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
- Prime Healthcare (Chula Vista, CA)
- …Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non- managed care environments.2. Experience in ... the changing needs of our community. Our 291-bed, acute care hospital features the San Diego Spine & Joint...of the CSU under the direction of the CSU Manager to assist with development and implementations of discharge… more
- J&J Family of Companies (San Diego, 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 . The OS has primary responsibility for developing the...hospital and large account sales, understand complex reimbursement and managed care dynamics with a documented history… more
- Molina Healthcare (San Bernardino, CA)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America ... new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified… more
- UCLA Health (Los Angeles, CA)
- …services + Exceptional interpersonal, written, and verbal communication skills Preferred: + Certified Case Manager (CCM), preferred + At least one year of ... of Behavioral Sciences + Three or more years of Case Management/ Care Coordination experience in a healthcare...experience in a managed care or health plan setting, preferred… more
- University of Southern California (Alhambra, CA)
- …and approval. Applies proficiency in understanding and applying contractual terms of our Managed Care contracts (ie, PPO, HMO, EPO, POS, Medi-Cal, Medicare, ... as needed. Communicates identified billing issues and trends to Supervisor and Billing Manager in a timely manner. Communicates issues with claim scrubber edits to… more