- Stanford Health Care (Menlo Park, CA)
- …budgets, and provide progress status reports to key stakeholders, which may include physician leaders and executive leadership. + Review and assess performance ... tangible results for both the facility and the planet. + **Lead Medical Sustainability Projects:** Steer the preparation, progress, and reporting for sustainability… more
- Elevance Health (Walnut Creek, CA)
- …+ Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. ... meets medical necessity criteria or requires additional medical necessity review . + Conducts initial ...hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management,… 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 ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Providence (Santa Rosa, CA)
- …minimize the risk by collaborating with management, medical staff and medical center personnel. Provides payor/ utilization review organizations with ... patients throughout their admission to ensure the availability of sufficient clinical and medical center resources. Communicates on a daily basis with medical … more
- Ventura County (Ventura, CA)
- …that establish, expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities ... of their journey. THE POSITION: Under direction of a physician or registered nurse, the Field Based Psychiatric Technician...such as utilization review , monitoring and evaluation procedures, and… more
- The County of Los Angeles (Los Angeles, CA)
- …proof of vaccination against COVID-19 or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates should not ... hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty...Incumbents seek the expert opinion or advice of a physician whenever the incumbent determines if a case falls… more
- Actalent (Sacramento, CA)
- Utilization Review Nurse (LVN) - InpatientPrimary Responsibilities + Perform timely utilization reviews for Medicare inpatient admissions, continued stays, ... reviews. + Escalate complex or ambiguous cases to the Medical Director or Physician Reviewer. + Ensure...ICU). + At least 1 year of experience in utilization review , case management, or hospital discharge… more
- Sedgwick (Sacramento, CA)
- …narcotic use contract with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost savings, ... and dosage, and monitor complex drug regimens; to provide medical necessity reviews to evaluate, implement, and monitor options...and data collection. + Interacts and coordinates work of physician advisors as needed; performs complex review … more
- HCA Healthcare (Campbell, CA)
- …and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Sharp HealthCare (La Mesa, CA)
- …required within 90 days of hire. **Essential Functions** + Verification and review of medication ordersReviews all medication orders for appropriate dose, duration, ... protocols and consultation with the interdisciplinary team.-Completion of a daily profile review for each patient consisting of the following elements:* Age, sex,… more