- Evolent (Sacramento, CA)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more
- Evolent (Sacramento, CA)
- …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more
- HCA Healthcare (Campbell, CA)
- …+ Interact daily with all departments within PPMSI, which include Customer Service, Utilization Management , Data Management and Network Management . ... encourage you to apply for our Managed Care Network Management Coordinator opening. We promptly review all...Care Network Management Coordinator opening. We promptly review all applications. Highly qualified candidates will be contacted… more
- City and County of San Francisco (San Francisco, CA)
- …timely coding and compliance with regulatory requirements in coordination with Utilization Management , Patient Financial Services, and Revenue Integrity. + ... and direction for multiple clinic-wide functions within the Health Information Management (HIM) - Mid Revenue Cycle Department, overseeing key functions that… more
- Sharp HealthCare (San Diego, CA)
- …skills in area of expertise. + Proficient knowledge and understanding of utilization management , case management , healthcare finances, alternative care ... clinical experience in area of specialty. + 2 Years Utilization /Case Management experience, preferably in a Managed...the first 12 hours of data to complete admission review .Documents assessment and IQ/guideline review data per… 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
- The County of Los Angeles (Los Angeles, CA)
- …the following: + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT ... the work of staff, and evaluating employee performance. For this examination, Utilization Review is defined as provides technical and administrative direction… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... + A minimum of three years of experience in utilization management , preferred + Team leading or...+ Working knowledge of laws, rules, and regulations regarding utilization review and discharge planning functions of… more
- Humana (Sacramento, CA)
- …Clinical Drug Policy Management team which ensures synchronization of formulary utilization management policies across multiple systems. Humana is seeking a ... and maintenance of clinical tools which help facilitate clinical medication review decision making. + Responsible for operationalizing prior authorization criteria… more
- Evolent (Sacramento, CA)
- …**What You'll Be Doing:** 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 ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more