- Evolent (Sacramento, CA)
- …Clinical Reviewer, Interventional Pain Management, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more
- Stanford Health Care (Palo Alto, CA)
- …Stanford Health Care **What you will do** + Inpatient & SNF Utilization Management & Care Coordination: + Support proactive hospital discharge planning, transfers, ... providers, caregivers, family, and the patient. + Identify opportunities to improve utilization , quality of care, access issues and physician profiling. + Acts as… more
- Evolent (Sacramento, CA)
- …As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more
- Magellan Health Services (San Diego, CA)
- …collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or ... outpatient care settings. Collects and analyzes utilization data. Assists with discharge planning and care coordination. Provides member assistance with mental… more
- Hospice Of San Joaquin (Stockton, CA)
- …the Hospice philosophy and Hospice's services. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW: Ensures compliance with the program plan, assuring quality ... service and appropriate utilization of resources. +... of resources. + Participates in Quality Assessment/Improvement and Utilization Review activities as requested by administration. + Incorporates… more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse ... medical necessity. The position partners with both the Pre-Service and In-Patient Utilization Management teams. Ensures to monitor and assure the appropriateness and… more
- NVIDIA (Santa Clara, CA)
- …technical competence with cloud concepts What you'll be doing: + Colossus Utilization & Cost Model Development: Design, build, and maintain comprehensive cost models ... Develop and automate reports and dashboards to visualize key cost and utilization metrics for different collaborators. + Tooling & Automation: Evaluate, implement,… more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team members ... of Utilization Management, Patient and Provider Services, Claims Department and...Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as needed. + Assists the Case/Care… more
- Stantec (Santa Maria, CA)
- …are actioned. - Regularly monitors forecasting, backlog, EVA, WIP, AFDA, DSO and utilization to identify issues and ensure they are addressed. - Responsible for ... office matters including employee relation issues - Responsible for achieving utilization rate and backlog targets including collaboration with other contributing… more
- Evolent (Sacramento, CA)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more