- Prime Healthcare (La Palma, CA)
- …Discharge Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non- managed care environments.2. Active ... a difference. Founded in 1972, La Palma Intercommunity Hospital is a 141-bed acute- care community hospital and the only hospital in La Palma. Our highly qualified… more
- UCLA Health (Los Angeles, CA)
- …improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams ... + 5 or more years of experience in Medicare Advantage or Part D Managed Care environment. + Hands-on experience conducting and leading RADV audits, highly… 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, ... and Vivant Health standards + Monitor daily inpatient census for Vivant Health- managed members across contracted hospitals + Support discharge planning and identify… more
- KBR (San Diego, CA)
- …order to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations. * Assess ... started. KBR maintains a highly qualified workforce to help care for service people and astronauts. We are looking...We are seeking a stellar Special Operations Nurse Case Manager that will provide a full range of professional… more
- Dignity Health (Santa Maria, CA)
- …Health experience **Special Skills:** + Demonstrates ability to work within a case- managed model of patient- care delivery. + Demonstrates proficient intermediate ... Staff LVN is a practitioner who demonstrates in-depth knowledge of nursing patient care and the ability to practice independently within the confines of educational… 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 ... Description Under the direction of the Transplant Financial Manager , performs administrative support to the Transplant Financial Referral Program. Responsibilities… more
- Ford Motor Company (Sacramento, CA)
- **Role Overview:** As the Enterprise Data Governance Manager you will be instrumental in transforming Ford's data landscape. You will bring to life our Enterprise ... Data Council (EDC) strategy, ensuring data is managed and leveraged as a strategic asset across the...medical, dental, and prescription drug coverage + Flexible family care , parental leave, new parent ramp-up programs, subsidized back-up… more
- CommonSpirit Health (Rancho Cordova, CA)
- …supervisory role highly preferred + Experience in Utilization Management, Case Management or Care Coordination, Managed Care is preferred **Where You'll ... completing quality assurance reviews of work performed and communicating with department manager and director the outcomes of the review and any identified issues… more
- CenterWell (Sacramento, CA)
- …minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates ... caring community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Molina Healthcare (San Bernardino, CA)
- …new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified ... Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case… more