- Trinity Health (Fresno, CA)
- …This position coordinates utilization review service for defined patient populations across the acute care continuum. This includes discharge planning, utilization ... management, care coordination collaboration, and support for resource utilization. This position works collaboratively with an interdisciplinary team to improve patient care through the effective utilization of the facility's resources. 1. Current licensure as… more
- Ventura County (Ventura, CA)
- …with attention to quality and cost-effective methods. Delegates performance of routine QA/ UR activities to the QA/ UR Nurses based upon guidelines approved ... Ensures that Committee activities follow the guidelines set forth in the QA and UR Plans and that Committee actions and assignments are completed in a timely manner… more
- Datavant (Sacramento, CA)
- …Experience: 3 to 5 years acute care experience + 2 years Health Plan or Acute Care UR /CM + Preferred Experience: 5 years acute care or health plan UR /CM with 1 ... year ICU/ER We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified… more
- Elevance Health (Costa Mesa, CA)
- …to, length of time off work, type and quantity of medications prescribed, Client UR and State IMR decisions, total duration and cost of care, compliance with MTUS ... and other industry standards, results of the Complaints & Grievances process, State Medical Board postings, and Anthem Commercial PPO ETG assessments. This person will be responsible for all product outputs currently being sold as Elevance Health Insights to… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …detailed records of appeals. + Recordkeeping: Maintains appropriate records (AIS, UR forms/charts, Peer to Peer log and Medicare forms) and substantiate ... activity by documentation that is entered in a clear, concise, organized and timely manner. + Medical Necessity: Attend Treatment Team on a daily basis and collaborate with clinical team to answer clinical questions related to medical necessity and patient… more
- Prime Healthcare (San Dimas, CA)
- …+ Must meet the performance standards set forth by the Hospital/ Department at UR Coordinator position for at least 6 months. + 1+ year of clinical experience ... in acute care setting preferred. + Excellent written and verbal communication skills. Excellent critical thinking skills. Pay Transparency San Dimas Community Hospital offers competitive compensation and a comprehensive benefits package that provides employees… more
- Providence (Mission Hills, CA)
- …Nurse License upon hire. + 2 years of experience working in a remote UR environment or working as an acute hospital case manager. **Preferred Qualifications:** + ... Bachelor's Degree in Nursing. + Master's Degree in Nursing. + Experience working with Interqual guidelines. + Experience in a multi-hospital and/or integrated healthcare system. **Why Join Providence?** Our best-in-class benefits are uniquely designed to… more
- General Motors (Mountain View, CA)
- …APIs, while orchestrating workflows through internal and third-party tools. **Yo** ** ur Skills & Abilities (Required Qualifications)** **:** + 7-10years' experience ... required of software engineering, fluency in .NET, Python or Java. + Bachelor's degreein Computer Science, Data Science, AI/ML, or equivalent experience. + Understanding of machine learning, deep learning, and statistical modelling. + Familiarity with… more
- BrightSpring Health Services (Anaheim, CA)
- …are passionate about assisting people reach their highest level of independence! O ur therapy team executes customized treatment plans that deliver real results and ... exceed patients' expectations. If you're motivated to give our clients a more positive quality of life, we encourage you to apply today! Current availability needs: Monday - Friday between the hours of 1:00pm - 8:30pm (2-5 hrs/day) Cities include: Irvine,… more
- BrightSpring Health Services (San Bernardino, CA)
- …and Developmental Disabilities reach their highest level of independence! O ur therapy team executes customized treatment plans that deliver real results ... and exceed patients' expectations. If you're motivated to give our clients a more positive quality of life we encourage you to apply today! Qualifications: Must be a Board Certified Behavior Analyst (BCBA). Must have experience implementing Applied Behavior… more