- Elevance Health (CA)
- …team to facilitate the administrative components of clinical referrals for case management or disease management services to include home health, nutritional ... completeness and follows up for additional information. + Assigns referrals to staff . + Verifies insurance coverage and obtains authorizations from insurance plans.… more
- Elevance Health (CA)
- …May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. ... with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- PRIDE Industries (Roseville, CA)
- …**POSITION SUMMARY:** Under supervision of the Workforce Inclusion Compliance Manager , the Workforce Inclusion Compliance Auditor assists in providing quality ... Employees in this job classification provide quality-related advisory services, case management support, internal training, and documentation audits. This job… more
- Travelers Insurance Company (Walnut Creek, CA)
- …with insured based on application of policy information to facts or allegations of each case . + Consults with Manager on use of Claim Coverage Counsel as needed. ... resource to the field and our business partners. This job does not manage staff . **What Will You Do?** + Directly handles assigned severe claims. + Provides quality… more
- Maxim Healthcare (San Bernardino, CA)
- …complaints and changes in condition to management teams including appropriate payer and case manager + Enters all appropriate patient information into the system ... Coordinator works closely with the Client Coordinator and other staff members to guarantee accuracy and timeliness of patient...the initial intake of patient needs and assisting with case coordination to ensure a high degree of customer… more
- Cedars-Sinai (Los Angeles, CA)
- …under the general direction of the HID CDI/Core Measures Supervisor or Manager , with responsibility for improving the overall quality and completeness of clinical ... modifications to clinical documentation through extensive interaction with physicians, nursing staff , other patient caregivers, and medical records coding staff … more
- Stanford Health Care (Palo Alto, CA)
- …both orally and written, to a variety of individuals including: patients, case workers, social workers, hospital directors and executives while maintaining utmost ... service. Clears low risk cases, escalates high-risk cases to coordinator or manager . Contacts patient regarding steps required to clear their appointment for… more
- MAAC (Metropolitan Area Advisory Committee) (Imperial, CA)
- …high-quality programs and advocacy in our communities. MAAC employs dedicated staff who provide life-changing services to thousands of individuals annually through ... passionate about workforce development. This position will report to the Community Development Manager and have a dotted line to the Workforce Development Manager… more
- LA Care Health Plan (Los Angeles, CA)
- …Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required Training Physical Requirements Light ... Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range… more
- Live Nation (El Cajon, CA)
- …responding to customer inquiries and complaints. + On an ongoing basis leads and train staff to include assisting in staffing positions to ensure that all staff ... of the Ushers and communicate with management (or designated Manager ) any challenges and status of all assignments prior...Nation will also provide reasonable religious accommodations on a case by case basis. HIRING PRACTICES The… more