- Evolent (Sacramento, CA)
- …informatics professionals who work with national health plans to ensure that prior authorization and financial coding stay accurate, compliant, and aligned with ... Management plays a crucial role in supporting the comprehensive management of prior authorization and financial scope within Evolent Specialty Services. Reporting to… more
- Sacramento County (Sacramento, CA)
- …Applicants are encouraged to take the PELLETB and receive the results (T-score) prior to submitting an application. Information about where to take the PELLETB is ... may also conduct a background check on the candidate prior to appointment to a position within this class....license, or comply with state and federal requirements for utilization , may constitute cause for personnel action in accordance… more
- Humana (Sacramento, CA)
- …communication skills. + Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization ... the managed care industry including Medicare Advantage and Managed Medicaid. + Utilization management experience in a medical management review organization, such as… more
- The County of Los Angeles (Los Angeles, CA)
- …until the needs of the service are met and is subject to close without prior notice The LA County Board of Supervisors recentlydeclared a local state of emergency ... analysis, and making recommendations to line managers on matters such as utilization of personnel, allocation of funds, workload and workload fluctuations, and… more
- Planate Management Group LLC (San Diego, CA)
- …involves developing strategies, plans, and policies that promote efficient space utilization across the base's infrastructure, ensuring compliance with Air Force ... Optimization Plan (FSOP) and related studies. + Analyze and implement space utilization strategies to support current and future mission needs. + Interpret space… more
- LA Care Health Plan (Los Angeles, CA)
- Authorization Technician II (12 Month Assignment) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... that purpose. Job Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative and technical functions… more
- CVS Health (Sacramento, CA)
- …the direction of the Lead Clinical Psychologist, this position will focus on utilization , quality, and review of fraud, waste, and abuse for individual Aetna member ... clinical criteria based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols. + Serve as a… more
- Meta (Menlo Park, CA)
- …analysis. To address this critical company-wide business needs, the Capacity Utilization Efficiency and Observability team focuses the following critical areas: ... capacity shapes and compute abstractions, data foundation platforms for efficiency/ utilization analytics and insights, and metrics correlated with workload… more
- Sharp HealthCare (San Diego, CA)
- …manage enterprise initiatives that support pharmaceutical contracting, procurement, distribution, utilization and reimbursement in the hospital and ambulatory care ... disciplines to create standard protocols and guidelines for cost effective drug utilization based on site of care. + ContractingCollaborates with Contract's team to… more
- Humana (Sacramento, CA)
- …communication skills . + Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization ... insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, such… more