- Evolent (Sacramento, CA)
- …Be Doing:** As a Clinical Reviewer, Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not...are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes… more
- Evolent (Sacramento, CA)
- …Be Doing:** As a Clinical Reviewer, Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not...are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes… more
- Jacobs (Los Angeles, CA)
- …other methodologies including, but not limited to, Asset Condition Assessment, Criticality Review and Risk Based Optimization. In this role, you'll ultimately ensure ... initiative, aimed to keep the preventive maintenance program up to date * Review and recommend new technologies aimed at improving equipment life cycle * Defines… 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
- 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
- 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
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to influence department's… more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse ... of defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for physician … more
- AECOM (San Francisco, CA)
- …in order to be able to identify support personnel and facilitate the quality review process for any regional project. In the event quality issues are identified, ... major pursuits by actively participating in the development and review of Project Plans and incorporation of other project...set up tools. + Support operations by balancing architecture utilization and staffing across the region as well as… more
- Genesis Healthcare (Carmichael, CA)
- …Clinical Operations Area Director in the timely completion of the annual merit review for therapy staff. 7. Assists Clinical Operations Area Director in the hiring ... 8. Participates in and coordinates the timely completion of the annual merit review for therapy staff. 9. Assumes responsibility for hiring therapy staff (in… more