- Elevance Health (Costa Mesa, CA)
- …more complex situations. + May be assigned to work special projects relevant to medical call or general medical management policies, practices and procedures ... **Nurse Demand Management ** **Sign On Bonus:$3,000** Carelon Health is a...resources and nursing background to provide callers with appropriate medical information. + Provides caller with appropriate community resources… more
- Evolent (Sacramento, CA)
- …for utilization management while working in conjunction with the Senior Medical Director. May assist the Senior Medical Director in research ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Humana (Sacramento, CA)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management . + Utilization management experience in a medical management.... + Utilization management experience in a medical management review organization, such as Medicare… more
- Sharp HealthCare (San Diego, CA)
- … functions. Works collaboratively with other plan functions that interface with medical management such as provider relations, member services, benefits and ... departments of Health Services to support, provide assistance and direction in overall medical management effectiveness. Reports all issues of clinical quality … more
- Humana (Sacramento, CA)
- …industry including Medicare Advantage and Managed Medicaid products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management + Utilization management experience in a medical management review organization, such as Medicare Advantage… more
- Sharp HealthCare (San Diego, CA)
- …the Plan. + Works collaboratively with other plan functions that interface with medical management such as provider relations, member services, benefits and ... + Provides professional leadership and direction to the functions within the Medical Management Department (Utilization/Cost Management and Quality … more
- Centene Corporation (Sacramento, CA)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... Assist the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit.… more
- Humana (Sacramento, CA)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management . + Utilization management experience in a medical management.... + Utilization management experience in a medical management review organization, such as Medicare… more
- CVS Health (Sacramento, CA)
- …Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective ... care management solutions that promote high-quality healthcare for members. We...Use established guidelines to authorize services or escalate to Medical Directors as needed. + Navigate multiple computer systems… more
- Providence (Fullerton, CA)
- **Description** The Medical Assistant (MA II) works under the delegation of a licensed practitioner to perform duties as directed to assist in providing patient care ... to assigned patients. A Medical Assistant (MA II) performs all aspects of the...Shift:** Day **Career Track:** Clinical Support **Department:** 7520 PAIN MANAGEMENT CA VAL MESA CLINIC **Address:** CA Fullerton 100… more