- UCLA Health (Los Angeles, CA)
- …well as oversight of clinical programming, adherence to department budget, ongoing review of purchasing and utilization of personnel resources, compliance with ... policies, standard operating procedures, and maintenance of staff morale and a healthy department culture, and other roles and functions at the discretion of the Associate Chief. You will cultivate a collegial, professional, cooperative relationship with… more
- Stantec (Irvine, CA)
- …to enhance our reputation and drive revenue. - Establish an effective Go/No Go Review process with Principals and track compliance. - Partner with other BCPLs and ... maintained and monitor to optimize business development plans and employee utilization rates. - Maintain and enhance local marketplace reputation through established… more
- Stantec (Sacramento, CA)
- …to enhance our reputation and drive revenue. - Establish an effective Go/No Go Review process with Principals and tracks compliance of Go/No Go Process - Partners ... maintained and monitor to optimize business development plans and employee utilization rates - Ensure local marketplace reputation through established relationships… more
- Sharp HealthCare (San Diego, CA)
- …improve clinical outcomes including responsibilities relating to leading teams in the utilization of Change Acceleration Process and PI tools and providing feedback ... issues through measurement and analysis along with concurrent and retrospective review of performance information. Assists with operational planning and development… more
- Elevance Health (Los Angeles, CA)
- …on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Sharp HealthCare (San Diego, CA)
- …Will Do** The position is responsible for the medical direction of Authorization Review for Sharp Health Plan (SHP). The Physician Reviewer will perform all ... reasonably necessary functions to ensure quality of care and appropriate utilization in the most cost-effective, appropriate and professional manner, which meets the… more
- Evolent (Sacramento, CA)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- J&J Family of Companies (Santa Clara, CA)
- …We invite candidates from various locations to apply and encourage you to review the following states where this opportunity is available: We are searching for ... development and clinical success, including procedure sales, support and driving utilization for all Johnson & Johnson's Surgical Robotics Technologies. The Senior… more