- Ventura County (Ventura, CA)
- …in-services and staff development programs; + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments; ... and + Performs other related duties as required. Typical Qualifications These are entrance requirements to the exam process and assure neither continuance in the process nor placement on an eligible list. EDUCATION, TRAINING, and EXPERIENCE Requires six (6)… more
- Dignity Health (Merced, CA)
- …efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality ... patient care. **Job Requirements** **Education and Experience:** + Masters Degree in Social Work from a university or college accredited by the Council of Social Work Education. + Minimum of three (3) years in a hospital based Clinical Social Work role,… more
- LA Care Health Plan (Los Angeles, CA)
- …by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health ... Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs. Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric… more
- Dignity Health (Long Beach, CA)
- …when appropriate, discharge planning activities, and coordination with the multidisciplinary team/ Utilization Review Case Manager for referral to a CCS-paneled ... provider or CCS Medical Therapy Unit for patients who may continue to require Occupational Therapy services after hospital discharge. **Job Requirements** _Level I:_ + No prior experience required. _Level II:_ + Minimum one year experience as an Occupational… more
- Stanford Health Care (Palo Alto, CA)
- …+ ICU/ED and Academic Medical Center experience preferred. + Case management, utilization review and/or direct provider interaction experience, preferred. + ... Experience in public speaking, as well as educational content creation and delivery of formal multidisciplinary education, preferred. + Experience with Vizient, Premier, Elixhauser and other risk adjustment methodologies, highly preferred. **Required… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , and scheduling requirements.Able to operate and maintain department ... equipment. **Knowledge, Skills, and Abilities** + Knowledge of eye medications, use and care of instruments, and sterile techniques is required. + Successful completion of skills inventory. Sharp HealthCare is an equal opportunity/affirmative action employer.… more
- VNA Health (Santa Barbara, CA)
- …inservice and nursing staff meetings. + Participate in Quality Management and Utilization Review Activities. + Maintain necessary records and reports in ... a timely manner. + Applies working knowledge of state, federal local and accreditation regulations for the delivery of hospice services. + Completes, maintains and submits accurate and relevant clinical notes regarding patient's condition. Records pain,… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …documentation of admissions to the Business Office, Admitting Unit and the Utilization Review Department. + Maintains knowledge of developmental tasks and ... sociological theories of pertinent age groups. + Maintains knowledge of legal guidelines pertaining to Emergency Medical Treatment & Labor Act (EMTALA)/Consolidated Omnibus Budget Reconciliation Act (COBRA) and abuse/neglect reporting. + Communicates with… more
- Ventura County (Ventura, CA)
- …and patient care as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments. + ... Performs other related duties as required. Typical Qualifications These are entrance requirements to the exam process and assure neither continuous in the process nor placement on an eligible list. EDUCATION, TRAINING, and EXPERIENCE: Requires six (6) months… more
- Deloitte (Los Angeles, CA)
- …nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN, Quality, DRG Validation and ... health IT preferred + Knowledge of Medicare reimbursement system and coding structures preferred + In-depth knowledge and experience in medical terminology, medical coding, and ICD-10-CM/PCS, IPPS payment system is a plus' + Experience in quality measurement,… more