- LA Care Health Plan (Los Angeles, CA)
- …achieve that purpose. Job Summary The Authorization Technician II supports the Utilization Management ( UM ) Specialist by handling all administrative and ... information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time… more
- Cedars-Sinai (Beverly Hills, CA)
- …member eligibility before processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director / Medical Director to research any ... and requests Letter-of-Agreements when requested. + Requests support documentation from IPAs / Medical Groups as requested by the UM Nurses, Medical … more
- Cedars-Sinai (Beverly Hills, CA)
- …member eligibility before processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director / Medical Director to research any ... Doing** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all...when requested. + Requests support documentation from IPAs / Medical Groups as requested by the UM … more
- Dignity Health (Rancho Cordova, CA)
- …criteria. This position will work closely with the hospitalist team, Dignity Health Medical Foundation Medical Director 's, specialists, clinic staff and ... and policies. Approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other. - Complete medical … more
- Sharp HealthCare (San Diego, CA)
- …business practices. **What You Will Do** Under the direction of the Sharp Community Medical Group (SCMG) Director for Health Service and in collaboration with ... legislative compliance for the division. Under the direction of the SCMG Director for Health Services, develops financial (budget) and operational strategy of HCM… more
- LA Care Health Plan (Los Angeles, CA)
- …to the Supervisor of ECM and receives clinical supervision as needed from the Medical Director of Care Management. The position is responsible for providing ... internal LA Care departments such as Care Management (CM), Utilization Management ( UM ), Managed Long Term Services...with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a… more
- Evolent (Sacramento, CA)
- …sources to establish and maintain the definitive source of truth for specialty Utilization Management ( UM ) agreements. This important work is achieved through ... and financial scope within Evolent Specialty Services. Reporting to the Director , Clinical Informatics, this role is responsible for acquiring, synthesizing, and… more