- Regeneron Pharmaceuticals (Los Angeles, CA)
- …highly challenging for HCPs and Patients. Payer Formularies and restrictive Utilization Management Criteria including: Prior Authorization Processes, Step Edits, ... knowledge on the local and national payer landscape, including Specialty Pharmacy and Utilization Management criteria for assigned products This role may be a… more
- GE HealthCare (CA)
- **Job Description Summary** The role of a Cardiac PET Senior Account Manager CPAM at GE Healthcare (GEHC) involves driving the timely adoption and growth of GEHC's ... judgment are required to achieve the desired outcomes. A Cardiac PET Senior Account Manager mentors non senior team members and may be called upon by the Sales… more
- North Marin Community Services (Novato, CA)
- …employer match, and childcare discount. With the guidance of the Director of Case Management and Housing, the CSS Manager provides oversight of the day-to-day ... programs and services. Works in partnership with the Senior Manager of Case Management and the Intensive...a focus on continuous quality improvement. + Ensure effective utilization of technology, including Apricot, HMIS, and other data… more
- Magellan Health Services (San Diego, CA)
- …of assigned care support teams. Experience with Care Management flows. Knowledge of utilization management procedures, mental health and substance ... appropriate and effective person-centered care plan, member education and care management . Conducts initial and concurrent review for prior authorization of higher… more
- City National Bank (West Hollywood, CA)
- *ACCOUNT SERVICES MANAGER * WHAT IS THE OPPORTUNITY? Responsible for the day-to-day interaction and relationship management support of an assigned portfolio of ... value and/or complex branch banking clients. In collaboration with the Branch Manager and Relationship Managers, the ASM works to address portfolio servicing needs,… more
- ICW Group (Woodland Hills, CA)
- …needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and coordinate appropriate medical treatment and length of ... monitoring to ensure quality and appropriate service delivery of the case management process. + Performs initial and ongoing clinical assessment via telephone calls… more
- Sharp HealthCare (San Diego, CA)
- …of two professional goals each year. (Goals to be determined by case manager and director).Promotes self-awareness and knowledge of current medical standards in ... (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for Case Manager ...system in multi-service referral, program development, and quality care management . The CCM will develop strong relationships with physicians,… more
- Cedars-Sinai (CA)
- … of EIS capital and operating budgets as assigned. + Provides strategic knowledge and management expertise to the Data & Analytics Delivery leadership ... " list, which highlights hospitals that have excelled in the utilization of electronic functionalities, telemedicine, digital imaging, artificial intelligence and… more
- Cedars-Sinai (Los Angeles, CA)
- …by payor, line of business and physician for trends and anomalies. Works with Utilization Management and Medical Directors to ensure an adequate panel of ... **Job Description** The Program Manager is responsible for supporting all facets of...integrity, physician network performance, patient and provider experience, and utilization management the best standard processes (specialty… more
- Elevance Health (Cerritos, CA)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... improve the delivery of care. **Title:** Behavioral Health Care Manager II **Location:** Woodland Hills, CA - 21215 Burbank...of experience in a managed care organization in a utilization management behavioral health role preferred. For… more
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