- Elevance Health (Walnut Creek, CA)
- …and external physicians. + Applies clinical knowledge and skills to utilization review processes. + Adheres to medical policies and clinical guidelines. + As ... **Behavioral Health Medical Director- Child Psychiatrist** Location: This role enables...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Elevance Health (CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... ** Medical Director** **Location:** This role enables associates to...Medicaid operations by providing clinical leadership and oversight across utilization management, appeals, and program innovation. This position ensures… more
- Elevance Health (Walnut Creek, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... **Behavioral Health Medical Director-Psychiatrist Appeals** **Location:** California. This role enables...with attending physicians or other ordering providers to discuss review determinations. + Serves as a resource and consultant… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION: ... the work of staff, and evaluating employee performance. For this examination, Utilization Review is defined as provides technical and administrative direction… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... - American Heart Association; Hospital Corpsman (HM) - US Navy; Certified Medical Assistant (CMA) - California Certifying Board for Medical Assistants… more
- Veterans Affairs, Veterans Health Administration (Santa Rosa, CA)
- …Scopes of Practice: The Advanced MSA coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization ... Summary The Advanced Medical Support Assistant (AMSA) is assigned to the...providers, and allied integrative health professionals. Responsibilities The Advanced Medical Support Assistant provides knowledge of programs, policies, resources,… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- The Chief Medical Officer (CMO) is a key member of Tiburcio Vasquez Health Center's (TVHC) Executive Leadership Team (ELT) and provides visionary and operational ... CMO is responsible for ensuring the delivery of high-quality, integrated, and accessible medical services across all of our health center sites and services. This… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... in a team based model. Members of a team may include Lead Medical Support Assistants, Program Support Assistants (PSA), Registered Nurses (RN) and AMSAs.… more
- Travelers Insurance Company (Sacramento, CA)
- …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical ...Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board… more
- Stanford Health Care (Palo Alto, CA)
- …various problem-solving techniques to deal with technical queries. + Demonstrated ability to review utilization reports and data. + Ability to identify trends ... stratification of at-risk patient populations, acute and skilled nursing facility concurrent review and complex and episodic case management, including the care plan… more