- Elevance Health (CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... a State agency.*_ **Preferred Skills, Capabilities and Experiences:** + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written,… more
- Mill Creek Residential (Oceanside, CA)
- …development and implementation of the site utilization plan + Assists Project Manager /Superintendent in the review and coordination of the Project Safety and ... At MCRT the Project Engineer will support the Project Management Team with the planning and daily execution in...use projects. The position will report to the Project Manager and Senior Project Manager . The position's… more
- Sharp HealthCare (San Diego, CA)
- …for admission to rehab, including patients not admitted, for reporting purposes, utilization review , marketing, and rehab administration and in compliance with ... PPS Certification required within 1 year of hire date. Management to track and maintain this certification - REQUIRED...data for monthly discharge reports, quarterly financial reports chart review and on ad hoc basis.Creates ad-hoc and scheduled… more
- Sunrise Senior Living (Simi Valley, CA)
- …and safety. + Provide leadership and promotion of the Sunrise Safety and Risk Management policies. + Review all incident reports and ensures corrective actions ... **JOB OVERVIEW** The Executive Director is responsible for overall leadership, management , and success of the community. Responsibilities include but are not… more
- Highmark Health (Sacramento, CA)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and procedures while… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... instruction. May schedule patient appointments.In partnership with physician, may review pre-printed teaching materials or written instructions from the provider… more
- LA Care Health Plan (Los Angeles, CA)
- …Specialist III works closely and collaboratively with Cultural and Linguistic (C&L) Manager , various internal C&L team members, client departments and vendors by ... through Plunet and Language Vault and all tasks associated including invoice review . Maintain translation memory, glossary and style guides for optimal translation… more
- Hensel Phelps (Irvine, CA)
- …Operational Project Readiness (OPR) and be the primary driver of the Commissioning Management (CxM) services on multiple projects. + Review contract documents ... + Establish testing/certification requirements for each piece of equipment for documentation management through Cx software platform. + ** Review Level 2 and… more
- CommonSpirit Health (Rancho Cordova, CA)
- …responsibilities leading up to or including supervisory role + Experience in Utilization Management , Case Management or Care Coordination, Managed ... for completing quality assurance reviews of work performed and communicating with department manager and director the outcomes of the review and any identified… more
- Amergis (Orange, CA)
- …Case Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management ) will be responsible for reviewing and ... as those listed above may also be qualifying. Preferred Qualifications: + Utilization management reviewer experience. + Managed care experience. + Behavioral… more