- Cedars-Sinai (Beverly Hills, CA)
- …and social supports required. + 1 year of previous utilization management or managed care experience; word processing spreadsheet skills also preferred. **Req ... of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the coordinator assists in… more
- Cedars-Sinai (Beverly Hills, CA)
- …resources and social supports required. One (1) year of utilization management or managed care experience preferred. **About Us** Cedars-Sinai is a leader in ... of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the coordinator assists in… more
- Illumination Foundation (Santa Ana, CA)
- …Wednesday/Thursday, 12:30pm-9:00pm. Responsibilities Referral Management & Evaluation + Review incoming referrals from hospitals, Managed Care Organizations ... Experience working with homeless or medically vulnerable populations + Familiarity with Managed Care Organizations (MCOs), IPAs, or hospital discharge procedures… more
- Sharp HealthCare (San Diego, CA)
- …settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience with InterQual or Milliman Guidelines. ... three days for the duration of the hospitalization.Facilitates timely referrals to social work and/or patient financial services for...and current standards of clinical practice. + Knowledge of managed care and Health Plan contracts. +… more
- Sharp HealthCare (San Diego, CA)
- …of medical terminology, eligibility, and benefit coverage preferably in a managed care environment. **Essential Functions** + Department SupportPrepares the ... Referrals for Prior AuthorizationCoordinate, review and process the more complex referrals for prior authorization for medical care and services, including… more
- UCLA Health (Los Angeles, CA)
- …guidance to patients and callers regarding the referral intake process + Processing managed care authorizations + Maintaining daily and weekly records of ... of the Transplant Financial Manager, the Transplant Financial Referral Coordinator provides essential administrative support to the Transplant Financial Referral… more
- UCLA Health (Los Angeles, CA)
- …information to incoming callers regarding the referral intake process. Process managed care authorizations. Typing, faxing and maintain daily/weekly records ... regarding internal and incoming transplant program referrals . Delivering CICARE World Class Care expectations in all dealings with patients, referring… more
- Actalent (Santa Barbara, CA)
- …(ambulatory, case management, or UM preferred) + Strong understanding of managed care principles and authorization workflows + Excellent communication, ... Registered Nurse to join a high-performing Utilization Management team supporting outpatient specialty care . This role is ideal for an experienced RN who thrives in… more
- Sutter Health (San Francisco, CA)
- … and/or authorizations accurately and consistently with minimal supervision. In Managed Care , processes authorization and referral requests for members ... in coordination with health plans and contracted providers. Provides support to the Case Management staff. Serves as a resource to providers regarding the authorization process. **Job Description** : **EDUCATION:** HS Diploma or GED **TYPICAL EXPERIENCE:** 2… more
- The County of Los Angeles (Los Angeles, CA)
- …meets with pharmaceutical product specialists to discuss current market conditions, managed care implications, disease state management, and obtain information ... the delivery of pharmacotherapeutics or pharmacokinetics in specialized medical care areas; designs, implements and conducts medication usage evaluations; delivers… more
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