- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As Needed / ... FTE:0.01 + Posted:August 21, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review...each individual in the classification. 1. Acts as a liaison between payers, billing, and medical staff by supplying… more
- Ventura County (Ventura, CA)
- …medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. + Participates, as ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- Cedars-Sinai (Beverly Hills, CA)
- …review process. The coordinator works collaboratively with all team members of Utilization Management , Patient and Provider Services, Claims Department and other ... with community resources and social supports required. One (1) year of utilization management or managed care experience preferred. **About Us** Cedars-Sinai… more
- Select Medical (Los Angeles, CA)
- …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... Management . **Responsibilities** + Clinical Interventions/Discharge and Care Planning Management : Responsible for functioning as the liaison among all… more
- STG International (Corona, CA)
- …to ensure compliance and patient safety. *Participates in quality improvement, care management , risk management , peer review, utilization review, clinical ... with the veteran and assist in making referrals for services and/or admissions to the VAMC as medically appropriate. Determine which referrals are required… more
- Sutter Health (Tracy, CA)
- …STCH-Sutter Tracy Community Hosp **Position Overview:** Provides leadership and management support in planning, organizing, staffing and controlling the operational ... to direct facility operations, and supervises personnel in all departments when leadership/ management staff is not present in the facility. During that time, serves… more
- Cedars-Sinai (Beverly Hills, CA)
- …+ As liaison coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... staff, insurance plans and other departments. + Actively participate in lean management processes by detailing, monitoring and updating department specific data. +… more
- UCLA Health (Santa Monica, CA)
- …to the team, individual, family or group psychotherapeutic treatment; liaison with community agencies; treatment plan documentation; and disposition planning ... patients to improve access to psychiatric care and to prevent unnecessary ED admissions and hospitalizations. In this role, you will have three main functions: 1.… more
- UCLA Health (Santa Monica, CA)
- …to the team, individual, family or group psychotherapeutic treatment; liaison with community agencies; treatment plan documentation; and disposition planning ... to improve access to psychiatric care and to prevent unnecessary ED admissions and hospitalizations. The clinical advisor has three main functions: 1. Resource… more