- Dignity Health (Bakersfield, CA)
- …contracted physician networks, impacting key performance indicators related to utilization and cost, quality, and both member and provider experience. This role ... Director of Utilization Management (UM) and the Medical Director of Physician Engagement and Quality, as well as providing clinical leadership and guidance to… more
- Evolent (Sacramento, CA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be a key member of the ... utilization management team. We can offer you a meaningful...and management staff, other Physicians, and staff whenever a physician `s input is needed or required. Aids and acts… more
- Ventura County (Ventura, CA)
- …direction, the Senior Medical Management Nurse is responsible for performing utilization review, case management, and quality improvement functions to ensure that ... may include but are not limited to the following: + Performs utilization review with pre-certification, concurrent, retrospective, out of network and medical… more
- Sharp HealthCare (San Diego, CA)
- …improve clinical outcomes including responsibilities relating to leading teams in the utilization of Change Acceleration Process and PI tools and providing feedback ... staff's quality of care and leads improvement projects to decrease variation in physician practice to improve clinical outcomes and reduce cost. Assists the hospital… more
- Sharp HealthCare (Chula Vista, CA)
- …other area of expertise. **Essential Functions** + Collect and compile utilization dataDocument collection efforts and results in ADT.Follows department guidelines ... resources are closed appropriately.Seeks clarity before completing the scheduling function when physician orders are not clear or refers to nurse for follow up.Asks… more
- UCLA Health (Los Angeles, CA)
- …computer information systems. These services include, but are not limited to: Referring physician line, SCOI and Physician Referral backline, referral source to ... UCLA Health, patient to physician communication, physician to physician ...a resource and contact for information and services, and utilization of our EMR system to communicate patient care… more
- Elevance Health (Walnut Creek, CA)
- …to members and providers. **How you will make an impact:** + Perform physician -level case review, following initial nurse review, of Medical Oncology regimens and ... supportive care. + Perform physician -level case review, following initial nurse review, of chemotherapy...and other staff in understanding the principles behind appropriate utilization of covered treatments and genetic testing. + Participate… more
- Cedars-Sinai (Los Angeles, CA)
- …the nationally recognized Cedars-Sinai Medical Center (Cedars-Sinai) and its affiliated physician network, major programs in physician and health professions ... Marina del Rey Hospital; Torrance Memorial Medical Center and its affiliated physician network, the leading healthcare organization serving Torrance and the beach… more
- Evolent (Sacramento, CA)
- …As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... interacts with leadership and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will Be Doing:** . Serve… more
- Evolent (Sacramento, CA)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... interacts with leadership and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will Be Doing:** + Serve… more