- CenterWell (Sacramento, CA)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- CenterWell (Sacramento, CA)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... 1 **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
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... provide requested clinical and psychosocial information to assure reimbursement. + Utilization Review -- Reviews prospectively, concurrently and retrospectively… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER , BOARD RELATIONS, HEALTH SERVICES (DIRECTOR, GOVERNMENTAL RELATIONS) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4203260) Apply ... MANAGER , BOARD RELATIONS, HEALTH SERVICES (DIRECTOR, GOVERNMENTAL RELATIONS) Salary...number of departmental contracts requiring the Board of Supervisor's review and approval. + Oversees the review … more
- Lompoc Valley Medical Center (Lompoc, CA)
- …degree preferred. + Experience: A minimum of two years of clinical experience in Utilization Review or Case Management is preferred. + Per Diem Positions: Case ... and hospital information systems required. Must demonstrate knowledge of current utilization management principles, third party payor review requirements,… more
- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... community and help us put health first** The Clinical Manager coordinates and oversees all direct care patient services...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Management/Executive Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible for the centralized… more
- BrightView (San Fernando, CA)
- …you can grow to be your brightest. We're looking for a Regional Equipment Manager . Can you picture yourself here? The Regional Equipment Manager is responsible ... provides direct support to branch leadership to drive optimal equipment utilization , vendor performance, and compliance with company standards. You'd be responsible… more
- The County of Los Angeles (Los Angeles, CA)
- EQUITY IN COUNTY CONTRACTS PROGRAM MANAGER (ADMINISTRATIVE MANAGER 10, ISD) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4613521) Apply ... EQUITY IN COUNTY CONTRACTS PROGRAM MANAGER (ADMINISTRATIVE MANAGER 10, ISD) Salary $119,695.68 - $161,306.16 Annually Location Los Angeles County, CA Job Type… more