- Dignity Health (Bakersfield, CA)
- …deep familiarity with the complexities of delegated services, including claims, utilization management , provider data, and network operations. Essential ... including needs assessment, business case development, stakeholder alignment, risk management , and sustainment planning. - EZCAP Automation Development: Collaborate… more
- CVS Health (Sacramento, CA)
- …experience in health care delivery (clinical practice) Experience in managed care, care management , utilization management , quality management , or ... products and programs as well as sales and account management . Duties include support for - case management... management . Duties include support for - case management , clinical content research & development, chronic condition … more
- Envista Holdings Corporation (San Diego, CA)
- …+ Ability to effectively manage assigned accounts in terms of driving utilization , customer relationship management , problem resolution, and business and ... + Ability to effectively manage assigned accounts in terms of driving utilization , customer relationship management , problem resolution, and business and… more
- Stanford Health Care (Palo Alto, CA)
- …reimbursements. + Knowledge of principles and practices of social services, case management , discharge planning, utilization management , and support ... | Stanford Health Care (SHC)? At Stanford Health Care, our Social Work/Case Management department is on a mission to emotionally support, assist, and empower… more
- Travelers Insurance Company (Sacramento, CA)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically… more
- Providence (Santa Monica, CA)
- …(Acute, Ambulatory, or Post-Acute). + 2 years of experience in Acute Care Management (Care Coordination or Utilization Management ) or successful completion ... **Description** **RN Care Manager for our Care Management Team at Providence Saint Johns Health Center...is Full-Time and will work 8-hour Day shifts.** Case Management is a collaborative practice including patients, caregivers, nurses,… more
- WelbeHealth (Elk Grove, CA)
- …strong, collaborative relationships with internal departments (eg, Clinical Operations, Utilization Management , Claims, Contracting, PACE Center Leadership) to ... effectiveness and streamline provider onboarding, training, and ongoing relationship management - this includes creating and updating training materials, standard… more
- Providence (Santa Monica, CA)
- …field (Acute, Ambulatory, or Post-Acute). + 2 years Experience in Acute Care Management (Care Coordination or Utilization Management ) or successful ... providing exceptional patient care and groundbreaking medical advancements. Case Management is a collaborative practice including patients, caregivers, nurses,… more
- Molina Healthcare (Long Beach, CA)
- …example, such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding. * ... and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability… more
- Providence (Orange, CA)
- …or medical office/clinic setting. **Preferred qualifications:** + 3 years of Experience in utilization management or case management + Experience with ... **Description** Care Management is a collaborative practice model including the...physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written,… more