- County of El Dorado (Placerville, CA)
- …clients and those that support co-occurring clients such as mental health clinicians, primary care providers, managed care systems and other health workers ... is desirable. Our ideal candidate is an energetic and compassionate counselor and care coordinator , is comfortable with advocating for the best care… more
- Humana (Sacramento, CA)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Knowledge of Medical Terminology and/or ICD-10 ... codes + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Bilingual (English & Spanish) fluent in… more
- Prime Healthcare (Victorville, CA)
- …Discharge Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non- managed care environments.2. ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/234790/ care - coordinator … more
- Dignity Health (Rancho Cordova, CA)
- …including HIPAA, CMS, and state-specific requirements **Preferred Qualifications:** - 2 years managed care experience preferred - 1 year delegation oversight ... DMHC, NCQA, CMS and other regulatory bodies preferred - Knowledge of HIPPA, managed care environment preferred - Strong technical proficiency in data analysis;… more
- Humana (Sacramento, CA)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM Administration … more
- Dignity Health (San Bernardino, CA)
- …care unit program through education to the community including healthcare providers and managed care organizations. This position acts as the MDS RN ... employee shall support Community Hospital of San Bernardino strategic plan and the goals and direction of the quality...within 6-12 months. + 6 months experience as MDS Coordinator in Long Term Care setting preferred.… more
- Cardinal Health (Sacramento, CA)
- …independently with minimal supervision. + Strong organizational skills. + Understanding of managed care contracts and fee schedules, including Medicare and ... Coordinator , Benefits Eligibility and Authorization **_What Benefits Eligibility...that may need to happen to not delay patient care . + Complete any pre-service appeals to obtain paying… more
- Dignity Health (Stockton, CA)
- …hospitals and agencies who serve as referral sources, including utilization review and managed care companies. This position requires providing service to a one ... **Job Summary and Responsibilities** The Evaluator Coordinator is responsible for enhancing referrals and gathering...Core Values. The employee shall support the Organization's strategic plan and the goals and direction of the Performance… more
- Highmark Health (Sacramento, CA)
- …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... reviewer in monitoring and ensuring adherence to the health plan 's state and federal multiple drug benefit design offerings....to ensure that the needs of the provider and plan member are addressed in a courteous, helpful and… more
- University of Southern California (Alhambra, CA)
- …develop a plan of care , and as supported by the ambulatory care coordinator . 5. Ensures that a specific plan of care is in place for all ... within 24 hours of admission; Observation patients are effectively care managed on a daily basis; and...coordinator , timely completion of all tasks, from the plan of care . Provide coordination of … more