- Palisades Tahoe (Olympic Valley, CA)
- …with disabilities to perform the essential duties. The Wedding and Banquet Sales Manager is responsible for driving group business from the wedding, corporate, and ... Companies (DMCs) to generate referral business and enhance sales opportunities. CRM Utilization : Maximize the use of the Amadeus/Salesforce CRM system to track… more
- AlliedTravelCareers (Greenbrae, CA)
- …RN Case Manager with experience as follows: Must have strong Utilization Review and InterQual experience REQUIRED! Conducting patient initial assessments ... - 0730 to 1600 Specialty Type: Nursing Sub Specialties: Care Manager , MRI Technologist General Certifications: General Certifications(BLS/BCLS) Please CLICK HERE to… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/rn-case- manager utilization - ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll...following major functions: + Pre-service Authorizations/Denial Letters + Concurrent Review + Continuity of Care + Retro Claims +… more
- Providence (Irvine, CA)
- **Description** **RN Utilization Review at Irvine, CA. This position is Full- time and will work Remote 8-hour, Day shifts.** Provide prospective, retrospective, ... and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as… more
- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and concurrent ... utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically… more
- Prime Healthcare (Sherman Oaks, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case- manager - utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- Elevance Health (Costa Mesa, CA)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law. The ** Utilization Management Representative I** is responsible for coordinating cases for precertification… more
- Sharp HealthCare (San Diego, CA)
- …every patient identified per departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case ... health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers....quality of care issues encountered in the course of review .Serves as a resource for staff (as needed), and… more
