- Hospice Of San Joaquin (Stockton, CA)
- …the Director of Home Care Services and the direction of the RN Case Manager , according to the policies and procedures of Hospice of San Joaquin. CLINICAL SERVICES: ... and family. + Follows the treatment plan established by the Registered Nurse/Case Manager . + Follows the scope of practice when providing nursing care. + Makes… more
- Sharp HealthCare (San Diego, CA)
- …and CMS. Develops and implements new programs under the direction of the manager of in-patient care management and the Director of Utilization Management. ... Degree Health care related field **Other Qualification Requirements** + Utilization , Case Management, or Quality Management certification preferred. **Essential… more
- The County of Los Angeles (Los Angeles, CA)
- …under the immediate supervision of a Data Scientist Supervisor, or supervisor or manager responsible for the data analytics, research, or statistical function of a ... and prevention services including but not limited to forecasting utilization and cost, cost/finance analyses, cost-effectiveness analyses, and predictive/prescriptive… more
- Alameda Health System (Oakland, CA)
- …Care Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management. **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The following ... performed by each individual in the classification. + Coordinates all utilization review functions, including response to payor requests for concurrent and… more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** 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...processing authorizations. + Contacts facilities identified by the UM Nurses/ Manager /Director/Medical Director to research any issues (ie contract, discharges,… more
- Stantec (Santa Maria, CA)
- …are actioned. - Regularly monitors forecasting, backlog, EVA, WIP, AFDA, DSO and utilization to identify issues and ensure they are addressed. - Responsible for ... matters including employee relation issues - Responsible for achieving utilization rate and backlog targets including collaboration with other...Where appropriate, be a key member or lead account manager for major clients of the BC or business… 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...processing authorizations. + Contacts facilities identified by the UM Nurses/ Manager /Director/Medical Director to research any issues (ie contract, discharges,… more
- Highmark Health (Sacramento, CA)
- …and testing processes in partnership with the pharmacy benefits manager . The successful candidate will possess excellent communication, analytical, and ... RESPONSIBILITIES** + Monitor FDA-approvals, drug manufacturer pipelines, assess drug utilization reports, and write drug monographs for Committee review to… more
- Dignity Health (Glendale, CA)
- …will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post acute ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical...five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or… more
- Dignity Health (Los Angeles, CA)
- …will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post acute ... + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical...five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or… more