- The County of Los Angeles (Los Angeles, CA)
- …work at the direction of a rehabilitation therapist, social worker, or registered nurse . Incumbents are typically responsible for providing technical direction ... team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable...to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions… more
- Alameda Health System (Alameda, CA)
- …and a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate of accredited ... as required by OBRA and PPS. 3. Assists Case Manager with the transfer of patients to other health...assessments. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
- Highmark Health (Sacramento, CA)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Amergis (Orange, CA)
- … Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and processing ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more
- Elevance Health (Los Angeles, CA)
- **Appeals Nurse Reviewer I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... of clinical domains, including radiology, cardiology and oncology. The **Appeals Nurse Reviewer I** is responsible for conducting preauthorization, out of network… more