• Physician Advisor

    Sutter Health (Sacramento, CA)
    …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the ... to appropriately optimize the use of Sutter Health Internal Physician Advisor Services (IPAS). The physician...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
    Sutter Health (06/12/25)
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  • CDI Physician Advisor

    Sutter Health (Emeryville, CA)
    …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Bay **Position Overview:** The Physician Advisor (PA) is a key member of the hospital's ... to appropriately optimize the use of Sutter Health Internal Physician Advisor Services (IPAS). The physician...management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation… more
    Sutter Health (08/02/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our...Medi-Cal reimbursement. + Analyzes cases for referral to the physician advisor to ensure that the admission… more
    The County of Los Angeles (05/22/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of … more
    The County of Los Angeles (06/28/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    …placement (eg, inpatient, observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may ... System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening +… more
    Alameda Health System (07/29/25)
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  • Physician , Chief of Inpatient Medicine

    Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
    …required; Experience supervising physicians and supporting utilization management as a Physician Utilization Management Advisor (PUMA) is preferred; Must ... L. Pettis Memorial Veterans Hospital is recruiting for a Full-Time, Permanent, Physician , Chief of Inpatient Medicine and reports directly to the ED-Inpatient… more
    Veterans Affairs, Veterans Health Administration (06/15/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …pre-admission review , utilization management, and concurrent and retrospective review Process. Performs and mentor's physician training of A&G and UM ... selected utilization /cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations for updating current polices to meet… more
    Sharp HealthCare (07/19/25)
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  • Medical Director - Sharp Health Plan - Hybrid…

    Sharp HealthCare (San Diego, CA)
    …selected utilization /cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations. + Participates in the retrospective ... the membership. Serves as a medical manager and policy advisor to SHP and its Chief Medical Officer. Is...to accrediting and regulatory agency feedback. + Supports pre-admission review , utilization management, and concurrent and retrospective… more
    Sharp HealthCare (05/18/25)
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  • Case Manager I - Sharp Memorial Hospital - FT…

    Sharp HealthCare (San Diego, CA)
    …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... medical record and provides information to the department head as indicated. + Utilization review and utilization managementThe RN CM I will:Conduct… more
    Sharp HealthCare (07/13/25)
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  • Clinical Case Manager (RN-LCSW-LMFT - Sharp Mesa…

    Sharp HealthCare (San Diego, CA)
    …when not in use.Is knowledgeable of current laws and regulations regarding Utilization Review and Discharge Planning.Morning arrival time insures orderly ... + Data collectionParticipates in data and statistics collection as requested by Utilization Review , Service Line and Quality Improvement Committees. + Denial… more
    Sharp HealthCare (08/08/25)
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