- Molina Healthcare (Sacramento, CA)
- …experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. **Preferred ... License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **WORK SCHEDULE: Mon - Fri / Sun - Thurs / Tues - Sat shift will rotate with some weekends and holidays.** To all current Molina employees: If you are… more
- PennyMac (Moorpark, CA)
- …Initiate third party orders (title, appraisal, hazard, flood cert, credit, etc.) + Review and validate loan documents + Handle routine calls, emails and/or chat ... responses + Monitor work queues and intervening as needed + Perform other related duties as required and assigned + Demonstrate behaviors which are aligned with the organization's desired culture and values What You'll Bring + Associate's degree or equivalent… more
- San Diego Community College District (San Diego, CA)
- …Until Filled No Classification Title INTERDISCIPLINARY BASIC SKILLS-English Review |CBEST: Adjunct/Substitute Instructor POOL (non-credit) Working Title Adjunct ... Faculty Recruitment Limits Location District Wide Pay Information At the time that an offer of assignment is made, proper salary placement is contingent upon receipt of OFFICIAL (sealed) transcripts and Verifications of Previous Work Experience (if… more
- UCLA Health (Los Angeles, CA)
- …inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan and/or ... regulatory audits for medical appropriateness by using established clinical protocols and health plan resource tools + Assess compliance with healthcare regulations, accreditation standards, and organizational policies + Extrapolate and prepare a detailed,… more
- MUFG (Los Angeles, CA)
- …portfolios to identify deterioration or negative management control trends and review compliance with policies, guidelines, and regulations. + Prepare periodic Risk ... Profile & Monitoring Plans to outline key risk factors and allocate appropriate resources. + Analyze individual credits and/or credit relationships for quality, adherence to approval conditions, the accuracy of risk grading, and adequacy and accuracy of… more
- San Diego Community College District (San Diego, CA)
- …Closing Date: Open Until Filled No Classification Title CIVIL SERVICE REVIEW -CE/VOC: Adjunct / Substitute Instructor POOL (non-credit) Working Title Adjunct Faculty ... Recruitment Limits Location District Wide Pay Information You may view the current salary schedule by clicking here (https://www.sdccd.edu/about/departments-and-offices/human-resources/employee-relations/salary-schedules.aspx) . At the time that an offer of… more
- Sutter Health (Sacramento, CA)
- …management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness of healthcare ... reimbursement systems: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Patient Processing Service (PPS),Centers for Medicare and Medicaid Services (GR) Grouper (CMS) preferred. + Post-acute levels of care such as Home Health,… more
- Amergis (French Camp, CA)
- …+ Current RN licensure in state practicing + At least one year of Case Management experience preferred + Current CPR if applicable + TB questionnaire, PPD or chest ... x-ray if applicable + Current Health certificate (per contract or state regulation) + Must meet all federal, state and local requirements + Must be at least 18 years of age Benefits At Amergis, we firmly believe that our employees are the heartbeat of our… more
- Health Advocates Network (Arcata, CA)
- Benefits We Offer: + Comprehensive health, prescription, dental, vision, life, and disability plans + Competitive pay rates + Referral opportunities ? Refer a friend ... & Cash in! + Travel reimbursement and per diem allowances + Employee discounts + Educational opportunities Health Advocates Network was founded based on a shared aspiration to improve the way healthcare staffing is done. We are a company founded by healthcare… more
- UCLA Health (Santa Monica, CA)
- …Play a key role within a world-class health system. Help ensure the delivery of safe, award-winning care and positive patient outcomes. Make the most of your ... background and abilities. You can do all this and more at UCLA Health. In this important position, you will be responsible for the identification, collection, and entry of quality data for the Clinical Registries, Patient Safety Indicators (PSIs), and Hospital… more