- Elevance Health (Los Angeles, CA)
- …improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and applies ... equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or RN… more
- Elevance Health (Walnut Creek, CA)
- …providers and external physicians. + Applies clinical knowledge and skills to utilization review processes. + Adheres to medical policies and clinical guidelines. + ... must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military… more
- Medtronic (Irvine, CA)
- …dissemination, competitive strategy, promotional tactics, marketing campaigns, marketing channel utilization , and marketing metrics + Collaborate with US Commercial ... portfolio assets, including new asset creation, existing asset management, and asset utilization planning + Form strong relationships with KOLs, customers, and Sales… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …unit with regard to patient/family relations, environmental safety and effective resource utilization . The incumbent practices as a managing RN in the Operating Room ... with regard to patient/family relations, environmental safety and effective resource utilization . Major duties and responsibilities include, but are not limited to:… more
- Centene Corporation (Sacramento, CA)
- …regulatory guidelines + Assists with providing education to providers on utilization processes to promote high quality, cost-effective, and efficient medical care ... Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + For Health Net of… more
- Sutter Health (San Francisco, CA)
- …is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The RN Case ... and case management within a managed care environment. + Comprehensive knowledge of Utilization Review, levels of care, and observation status. + Some awareness of… more
- Select Medical (Los Angeles, CA)
- …of care necessary to ensure care plan delivery. Delegates and supervises the utilization of PTAs, as well as support personnel to maximize patient outcomes and ... ensure effective utilization of services. **Qualifications** **Minimum Qualifications** + Current state licensure or eligibility for state licensure as a Physical… more
- Fresenius Medical Center (Simi Valley, CA)
- …facilities. Ensures efficient staff/ patient scheduling and efficient staffing utilization following company policy while maintaining a safe environment. + ... and in compliance with all applicable regulatory requirements. + Ensures efficient utilization of supplies and equipment. + Assists with various projects as… more
- Elevance Health (CA)
- …Medicaid operations by providing clinical leadership and oversight across utilization management, appeals, and program innovation. This position ensures timely, ... must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military… more
- Elevance Health (Walnut Creek, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military ... Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. For… more