- Illumination Foundation (Stanton, CA)
- …Role The Program Coordinator is an administrator role dedicated to upkeep, management , and oversight of front-end and back-end programmatic processes. These include ... will also be centrally involved in communicating information to management and lead housing entities and will be relied...Health Network Portals and internal HER/AICA. + Upon referral review , note all questions that may need to be… more
- The County of Los Angeles (Los Angeles, CA)
- …predictive and prescriptive analytics, to support data-driven program design and management ; and produces dashboards, reports, and other advanced data visualization ... under the immediate supervision of a Data Scientist Supervisor, or supervisor or manager responsible for the data analytics, research, or statistical function of a… more
- Ventura County (Ventura, CA)
- …evaluation, and review ; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with guidelines and standards ... The ideal candidate is an experienced Mental Health Nurse with a background in utilization review and discharge planning. They also have extensive years of… more
- ICW Group (Sacramento, CA)
- …and trending of cost management issues related to bill review , case management and utilization review . + Works closely with Case Management ... with Cost Management Manager in tracking, resolution gathering,...Understanding of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review , Telephonic Nurse Case Management… more
- Dignity Health (Los Angeles, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Long Beach, CA)
- …emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Long Beach, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Glendale, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- LA Care Health Plan (Los Angeles, CA)
- …staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by maintaining an ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA,...(30%) Assist in the technical aspects of the retrospective review process for authorizations and Member or Provider Appeals,… more
- Highmark Health (Sacramento, CA)
- …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create...**Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management … more
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Medical Case Management Manager
- Apicha Community Health Center (New York, NY)