- Stanford Health Care (Palo Alto, CA)
- …Accountable Care Organization (ACO) Products, Stanford Medicine's Service Lines, Medical Office Buildings, and special projects. Brings innovative ideas, techniques ... continue to position the organization as a leading academic medical center. The role has both account-specific budget and...educate the community as well as maximize current slot utilization . + Coaches, mentors and manages assigned staff to… more
- Humana (Sacramento, CA)
- …to address identified gaps. They will work closely with established functions inside utilization management ( Medical Director , clinician decision making ... working with CMS Compliance Regulations + Experience working with medical directors in some capacity ie Committees, projects. +...capacity ie Committees, projects. + 3 or more years' Utilization Management Experience + 2 + years… more
- Cognizant (San Francisco, CA)
- …within the Retail and CPG space supporting Salesforce engagements in technical and management capacity. Focused on growing our client base, this role supports the ... real-time visibility into project health, financial performance, and resource management . Build and maintain strong collaborative relationships between practice and… more
- Elevance Health (CA)
- …in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses ... ** Medical Management Clinician Senior** **Location:** This... medical necessity denial determination made by a Medical Director . + Develops and fosters ongoing… more
- Cedars-Sinai (Beverly Hills, CA)
- …review process. The coordinator works collaboratively with all team members of Utilization Management , Patient and Provider Services, Claims Department and other ... eligibility before processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director / Medical Director to research any issues (ie… more
- Cedars-Sinai (Beverly Hills, CA)
- …review process. The coordinator works collaboratively with all team members of Utilization Management , Patient and Provider Services, Claims Department and other ... processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director / Medical Director to research any...and social supports required. + 1 year of previous utilization management or managed care experience; word… more
- HCA Healthcare (Riverside, CA)
- …in-service programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues, and ... program development, and overall hospital strategy + You will provide medical director services to facility-level physician credentialing, business development,… more
- Lompoc Valley Medical Center (Lompoc, CA)
- …and internal equity. Position Summary + Reports to the Director of Case Management + Plan, organize and deliver utilization management activities for BOP ... patients through the LVCHO including authorization of services + Deliver utilization management services and social service activities within the acute hospital.… more
- Sharp HealthCare (San Diego, CA)
- …the direction of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience ... planning consistent with existing policies and/or principles. Responsible for managing medical management activities to include tracking, trending and analyzing… more
- LA Care Health Plan (Los Angeles, CA)
- …reports to the Supervisor of ECM and receives clinical supervision as needed from the Medical Director of Care Management . The position is responsible for ... care with internal LA Care departments such as Care Management (CM), Utilization Management (UM),...with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a… more