- Providence (Fortuna, CA)
- …in Nursing or health related field. + CCM or ACM + 2 years case management , discharge planning, or utilization management experience in the acute, sub-acute, ... **Description** Care Manager RN - Case Management at Providence Redwood Memorial Hospital in Fortuna,...hospital personnel and outside resources to ensure the appropriate utilization of resources according to clinical and financial standards.… more
- Grifols Shared Services North America, Inc (San Francisco, CA)
- …than 110 countries and regions. The primary responsibility of the Bleeding Management Hospital Specialty Sales Representative (HSSR) is to represent key products ... within the Bleeding Management product portfolio with a primary responsibility for the...relationships in institutions aligned with customer segmentation. + Develop physician influencer champions to submit and approve P&T requests… more
- Sharp HealthCare (San Diego, CA)
- …potential providers for the Sharp Health Plan provider network.Works closely with utilization management and contracting teams to ensure network gaps are ... and maintaining positive working relationships through provider engagement and management . Develops and presents provider orientation/training and other resources to… more
- Sutter Health (Emeryville, CA)
- …clinical oversight and direction for critical health plan functions-including utilization management , credentialing, authorizations, concurrent review, and ... risk-based contracts. + Proven history of leading large multidisciplinary teams in care management , utilization management , and quality improvement. + Proven… more
- Sharp HealthCare (San Diego, CA)
- …of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience in the acute ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… 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 ... medical necessity. The position partners with both the Pre-Service and In-Patient Utilization Management teams. Ensures to monitor and assure the appropriateness… more
- Providence (Tarzana, CA)
- … management of the patient along the continuum of care, utilization activities, disease management appropriateness, discharge planning, patient education ... **Description** RN Manager of our Care Management team at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, CA. This management position is Full-Time… more
- Sharp HealthCare (Coronado, CA)
- …regulations. ICD-9, RVS, and CPT 4 coding. + Basic computer functions. + Basic utilization management . + Accurately type or on-line key 35-40 wpm. + Organize ... utilization .Informs appropriate leadership, staff, other departments and/or material management of case needs. + Department productionPatient/families are always… more
- Highmark Health (Sacramento, CA)
- …Therapeutics Committee review. + Assist in the development and implementation of utilization management programs including but not limited to: prior ... account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and disease management initiatives.… more
- Evolent (Sacramento, CA)
- …specialty match reviewer for Spine Surgery cases. you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more