- The County of Los Angeles (Los Angeles, CA)
- …administrative supervision to plan, assign, oversee, and evaluate the work of subordinate staff and provides technical guidance and support to staff within the ... and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in...and in a timely manner. Coordinates the delivery of staff training necessary to maintain mandated levels of services.… more
- Dignity Health (Rancho Cordova, CA)
- …efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality ... patient advocacy, clinical social work and best practice in medical necessity determination and concurrent review . This position will supervise the department in an… more
- University of Southern California (Alhambra, CA)
- …+ Req 5 years Clinical experience + Req 2 years Ambulatory case management or utilization review experience within the last three years + Req Ability to work ... The role integrates the functions of complex case management, utilization management, quality management, discharge planning assessment, and coordination of… more
- Sharp HealthCare (San Diego, CA)
- …when not in use.Is knowledgeable of current laws and regulations regarding Utilization Review and Discharge Planning.Morning arrival time insures orderly ... + Data collectionParticipates in data and statistics collection as requested by Utilization Review , Service Line and Quality Improvement Committees. + Denial… more
- Cedars-Sinai (Los Angeles, CA)
- …dedicated to patient evaluation, consultation, and care coordination, supported by three nurse practitioners and specialized staff . + **Theranostics** - the ... programs, ensuring excellence in training and education. + **Faculty and staff development.** The chair is responsible for attracting, mentoring, and developing… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... (AHA BLS Healthcare) - American Heart Association; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours**...and hiring teams._** **What You Will Do** Assists patients, staff and physicians as needed to maintain a high… more
- Providence (CA)
- …in a medical record. + 2 years - HEDIS, Quality management/quality improvement/ utilization review auditing experience, including experience in auditing within ... Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab...Communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that… more
- Datavant (Sacramento, CA)
- …healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in...letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... ensures accurate scheduling, and communicates with Veterans, providers, and clinical staff . Maintains HIPAA standards, resolves issues, and supports smooth clinic… more
- Dignity Health (Arnold, CA)
- …services provided; participate in annual review of patient health records and utilization review studies of the Clinic services + Maintain confidentiality of ... and minister medical treatments and medication; collaborate/supervise with the nurse practitioner/physician assistant in order to plan and coordinate patient… more