- Saildrone (Alameda, CA)
- …to meet specific project needs, optimizing build performance and resource utilization . * Troubleshoot and resolve build issues, including dependency management, ... software development best practices, version control systems (eg, Git), and code review processes. * Strong problem-solving skills and the ability to analyze and… more
- WM (Redding, CA)
- …vehicles are available to meet operational requirements. + Manages effective utilization of vehicle assets. + Conducts fleet evaluations to ensure maintenance ... and regulations to encourage safe and efficient operations. + Meets all financial review dates and corporate directed programs in a timely fashion. + Assists in… more
- Sharp HealthCare (La Mesa, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... 0 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager ...provides information to the department head as indicated. + Utilization review and utilization managementThe… more
- Ventura County (Ventura, CA)
- …general direction, the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ... but are not limited to the following: + Performs utilization review with pre-certification, concurrent, retrospective, out...Health Care Plan. + Experience working as a case manager in a health plan case managing complex cases.… more
- John Muir Health (Walnut Creek, CA)
- …of the 340B program. Reports any deficiencies identified during auditing and review for appropriate resolution. + Ensures that the 340B pharmacy program is ... adequate systems checks are reviewed to prevent future billing issues. + Monitors utilization records and 340B purchasing accounts to ensure that software or tools… more
- The County of Los Angeles (Los Angeles, CA)
- …under the immediate supervision of a Data Scientist Supervisor, or supervisor or manager responsible for the data analytics, research, or statistical function of a ... and prevention services including but not limited to forecasting utilization and cost, cost/finance analyses, cost-effectiveness analyses, and predictive/prescriptive… more
- RxBenefits (Los Angeles, CA)
- …correct and released. Job Responsibilities Include: + Operate as the central project manager for the business on new opportunity prospects, playing a pivotal role in ... schedules, channel management, B/G classifications, specialty designations, rebate eligibility, utilization trend, Utilization Management (UM) implications, Manufacturer… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager assigned to the SNF's for continued review and follow up. +… more
- Ventura County (Ventura, CA)
- …The ideal candidate is an experienced Mental Health Nurse with a background in utilization review and discharge planning. They also have extensive years of ... and review ; + Performs daily clinical reviews to support utilization and quality management, ensuring compliance with guidelines and standards for patients… more
- Elevance Health (Los Angeles, CA)
- …on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more