- Humana (Sacramento, CA)
- …Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical management review organization ... us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments… more
- Highmark Health (Sacramento, CA)
- …both internally developed and vendor-sourced criteria. This includes proactive monitoring, review , and timely updates in response to new evidence, regulatory ... data-driven insights from complex healthcare datasets (eg, claims, clinical, utilization , pharmaceutical) to inform policy development, identify areas for… more
- Three Saints Bay (Port Hueneme, CA)
- …functions + Two (2) years of experience directly related with utilization of Content Management Systems, learning Management Systems, and/or Sharable Content ... (R&M) Modeling, Prediction, Allocation and Analysis for program evaluations, review , or implementation. **Desired Qualifications:** + Demonstrated experience analyzing… more
- WSP USA (San Bernardino, CA)
- …in accordance with all acceptable engineering practices. + Perform engineering review of permit applications, engineering design plans and specifications, standby ... technical excellence through direct project delivery demonstrated by set performance utilization goal as Technical Excellence Practices Leader. + Key performance… more
- AON (Los Angeles, CA)
- …client service for assigned book of business including billing, policy collection, review and transmittal in accordance with established service standards. + Liaise ... recognize when more information is needed to make a decision. + Drive utilization of available technology, portals and resources. + Demonstrate ability with all… more
- Stanford University (Stanford, CA)
- …areas of oversight include signage inventory management and renewal, parking utilization data collection and analysis, License Plate Recognition (LPR) enforcement ... functional areas, including parking enforcement, signage management, asset audits, website content review , parking data collection, and the review of citation… more
- Elevance Health (Cerritos, CA)
- …facility-based and outpatient professional treatment health benefits through telephonic or written review . This role is a part of the team serving the commercial ... a requirement for this position. + Previous experience in case management/ utilization management with a broad range of experience with complex psychiatric/substance… more
- CommonSpirit Health (Rancho Cordova, CA)
- …performed and communicating with department manager and director the outcomes of the review and any identified issues or barriers. **Core Duties:** + Compiles data ... assessment to prioritize patient transfers based on urgency of patient's condition, utilization of available beds. + Communicate effectively with hospital staff to… more
- Global Foundries (Santa Clara, CA)
- …negotiate formal business agreements + Participate in operations, engineering, and business review meetings + Conduct weekly customer and channel partner face to ... processes which pertain to employees including recruitment, selection, training, utilization , promotion, compensation, benefits, extracurricular programs, and termination are… more
- San Jose State University (San Jose, CA)
- …grounds, automotive, recycling, and moving services + Oversee and ensure full utilization of the computerized maintenance management system to plan, schedule, track, ... service level plans, and performance metrics to ensure effective resource utilization and accountability + Provide strategic leadership in sustainability, energy… more