- LA Care Health Plan (Los Angeles, CA)
- …through Plunet and Language Vault and all tasks associated including invoice review . Maintain translation memory, glossary and style guides for optimal translation ... outcomes and review periodically. Monitor and manage vendors' performance through observation,...as needed. Prepare translation/alternative format sections of reports (eg utilization reports and annual evaluation), including but are not… 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
- Ryder System (San Francisco, CA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The " ... productivity tracking and optimization, shift and shop meetings, and RO review and approval.Directly involved in Labor Planning by evaluating incoming work… more
- Veterans Affairs, Veterans Health Administration (Ukiah, CA)
- …are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. EDRP ... more Duties and responsibilities of the LVN/LPN include: Performs retrospective medical review of non-VA health care records to determine medical necessity of visit,… more
- Veterans Affairs, Veterans Health Administration (Eureka, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... palpitation, auscultation, collecting vital signs. Incumbent performs retrospective medical review of non-VA health care records to determine medical necessity… more
- Pfizer (Sacramento, CA)
- …and applying insights in local planning * Act decisively by prioritizing resource utilization to meet customer needs * Provide key HQ colleagues, including Brand ... actionable, and solutions focused feedback * Ensure effective and compliant utilization of promotional materials. * Ensure successful, compliant selling activities… more
- CVS Health (Sacramento, CA)
- …RN states. This role is a blended role doing both Case Management and Utilization Management. The RN Case Manager is responsible for telephonically and/or face to ... - Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit...in critical care - 6+ months Case Management or Utilization Management experience - Must be able to work… more
- TriMas Corporation (El Cajon, CA)
- …through business analysis including product margin and customer margin analysis. Analyze, review and Report metrics to determine the operational effectiveness of our ... business processes and profitability. Key reporting includes: Direct labor efficiency and utilization - understand trends and profit impacts, work with operations to… more
- Amergis (Orange, CA)
- …help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and processing requests for ... providers. The incumbent will be responsible for prior authorizations, concurrent review and related processes. Position Details: Location: Orange (Full Office, no… more
- Humana (Sacramento, CA)
- …initiatives. + Collaborate with various operational functions in the centralized utilization management team and other shared services. + Participate in quality ... governance, peer review , and grievance resolution processes. Innovation & Transformation: +...provider or payer. + Thorough knowledge of health care utilization and quality metrics and the impact value-based contracting… more