- Evolent (Sacramento, CA)
- …: Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population health opportunities using SAS, SQL, Excel, and Power ... years of analytics & reporting experience in healthcare, including medical economics, cost/ utilization analysis, and membership trend reporting. + 2+ years of SQL… more
- Sutter Health (Roseville, CA)
- …Administration **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted criteria ... is met and at the appropriate level of care. Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care… more
- Evolent (Sacramento, CA)
- …Medical Director, Physical Medicine and Rehab 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
- The County of Los Angeles (Los Angeles, CA)
- …analysis, and making recommendations to line managers on matters such as utilization of personnel, allocation of funds, workload and workload fluctuations, and ... analysis, and making recommendations to line managers on matters such as utilization of personnel, allocation of funds, workload and workload fluctuations, and… more
- Cedars-Sinai (Beverly Hills, CA)
- …Will be Doing** 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 necessary. + Assists the Case/Care… more
- LA Care Health Plan (Los Angeles, CA)
- …care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and Support (MLTSS), Social Services, ... and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required Training… more
- Celonis (Redwood City, CA)
- …technical solutions that drive significant cost efficiencies and optimize resource utilization across our extensive cloud compute and storage infrastructure. You ... instance right-sizing, auto-scaling strategies, storage tiering, lifecycle management). + ** Utilization & Optimization Drive:** Lead and execute initiatives to… more
- Moss Adams LLP (CA)
- …Management team to plan and implement our people strategy, manage staff utilization , coordinate staff schedules, resolve conflicts and deploy people. This role ... human resources, and internal accounting to promote people development and maximize utilization . The Resource Management Senior will work to balance business needs… more
- Highmark Health (Sacramento, CA)
- …RESPONSIBILITIES** + Monitor FDA-approvals, drug manufacturer pipelines, assess drug utilization reports, and write drug monographs for Committee review to ... Formularies by monitoring FDA-approvals and drug manufacturer pipelines, assessing drug utilization reports, and writing drug monographs for Pharmacy & Therapeutics… more
- UCLA Health (Los Angeles, CA)
- …clinical programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group (FPG) Management Services Organization ... in ensuring the delivery of program functionalities in all aspects of Utilization Management and its integration with other patient facing programs within the… more