- UCLA Health (Santa Monica, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... teams + Knowledge of a large university teaching hospitals Preferred: Strong Utilization Review experience and understanding of CMS and other regulatory… more
- Sutter Health (San Francisco, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of ... care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post acute… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post acute… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post acute… more
- Dignity Health (Northridge, CA)
- …effectively. + Technical Skills: Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Customer Service: A commitment to ... and presentation skills to effectively collaborate with diverse stakeholders. + Utilization Management & Case Management: Understanding of how utilization … more
- Select Medical (San Diego, CA)
- …and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan ... patient-specific, safe and timely discharge plan. + Performing verification of utilization criteria reviews. + Building relationships and coordinating with payor… more
- University of Southern California (Arcadia, CA)
- …outside referring physicians andmedical groups.* Communicates with insurance company utilization review and authorization personnel.* Gathers and maintains ... physician in complex cases with multiple practitioners.* Ensures appropriate resource utilization relevant to the financial, regulatory and clinical aspects of… more
- Dignity Health (Glendale, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post acute… more
- Elevance Health (Walnut Creek, CA)
- …+ Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate on committees or in ... and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens and… more