- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, discharge planning, & obtaining… more
- Centene Corporation (Sacramento, CA)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...applicable guidelines, policies, and procedures + Works with the senior management to develop and implement UM… more
- Sharp HealthCare (San Diego, CA)
- …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective review Process. Performs ... risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs,...CMO CPTAC and Peer Review Committees. + Partners with Senior Management including CMO and COO to… more
- Ventura County (Ventura, CA)
- …Inpatient Psychiatric unit of the Ventura County Medical Center including utilization management , transfer coordination, discharge planning, and securing ... Senior Mental Health Nurse Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061656) Apply ...and review; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with… more
- Ventura County (Ventura, CA)
- …medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. + Participates, as ... a member of the Senior Management Team, in developing goals, plans...procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval… more
- Evolent (Sacramento, CA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Sharp HealthCare (San Diego, CA)
- …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective rev1ew process. + ... Participates in risk management , pharmacy utilization management , catastrophic...the ability to interface effectively with employees, members, physicians, senior management , and the public at large.… more
- The County of Los Angeles (Los Angeles, CA)
- …predictive and prescriptive analytics, to support data-driven program design and management ; and produces dashboards, reports, and other advanced data visualization ... to larger, more complex projects overseen by a Data Scientist or Senior Data Scientist. Predictive Data Analyst is distinguished from the higher-level Data… more
- Evolent (Sacramento, CA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Evolent (Sacramento, CA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more