- 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
- Veterans Affairs, Veterans Health Administration (Oceanside, CA)
- Summary The Mental Health Senior Social Worker (MHSSW) provides Mental Health services to Veterans enrolled at the VA San Diego Healthcare System. Responsibilities ... referral(s) to service providers and specialty treatment clinics, resource utilization and development, advocacy, crisis intervention, education and prevention, case… 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
- Evolent (Sacramento, CA)
- …initiatives. **What You Will Be Doing:** + Responsible for oversight of utilization management (UM)/care management (CM) correspondence development, internal ... issues requiring resolution to maintain progress on a timely basis. + Assists senior management with development/implementation of plan operations. On a regular… 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
- HCA Healthcare (Riverside, CA)
- …will assemble regional physician advisory panels to provide ongoing feedback to HCA senior management , and serves as a liaison between committees and ... review/ management + You will consult with facility-level staff regarding delegated utilization management and disease management operations under managed… more
- Evolent (Sacramento, CA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... cases. 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