- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …areas of risk management, infection control, environmental safety, quality control, and utilization review ; strong oral and written communication skills, current ... injury. Also, responsible for developing, implementing, and monitoring the quality review program. + Directs the collection, measurement, and presentation of data… more
- Highmark Health (Sacramento, CA)
- …cases, which may involve speaking with providers via phone.At times, build cases in Utilization Review system during high volume times. + May have responsibility ... audit issues to determine root cause of errors and recommend process improvements. Review error trends to identify training opportunities. + Other duties as assigned… more
- Cedars-Sinai (Marina Del Rey, CA)
- …the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for ... identified contracted/private patients collaborates with on-site and/or outside reviewers. + Keeps patients informed of progress and provides information related to disease progression. + Collaborates with discharge planner to make orders and arranges for home… more
- Sharp HealthCare (San Diego, CA)
- …response to therapeutic interventions via collateral calls, conjoint therapy sessions, utilization review process, and/or referrals and revises care plan ... issues.Identifies Bioethical dilemmas and initiates appropriate response.Testifies at Certification Review and Reise hearings regarding patient's current mental health… more
- Sharp HealthCare (San Diego, CA)
- …initiate, and support admissions process per policy and or department guidelines.Complete Utilization Review for admitting and ongoing treatment for patients. ... Do** To provide documentation for discharge planning, psychosocial, treatment plan, UR review , and care coordination for patients. Intake phone calls and assessment… more
- KBR (San Diego, CA)
- …compliance in meeting care goals. * Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... current notes in the electronic medical records of all patients contacted for review by the managing physician; Routinely staffs difficult cases with the referring… more
- Provider Solutions & Development (Mission Hills, CA)
- …of medical group management experience required + Must have working knowledge of utilization management and review essential to operations management and to ... the medical center and its physicians to improve clinical quality, resource utilization and increase value while maintaining and improving mission outcomes. You will… more
- Ventura County (Ventura, CA)
- …and patient care as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments. + ... Performs other related duties as required. Typical Qualifications Education/Experience: Requires six (6) months of recent full-time acute care registered nursing experience in an acute hospital or equivalent setting, or completion of the Ventura County Medical… more
- Actalent (Stockton, CA)
- …post‑acute facilities, including preparing documents and obtaining signatures + Support utilization review transmission and manage high‑volume faxes, voicemails, ... and data entry + Participate in daily rounds, huddles, and team discussions to support timely discharge planning + Maintain accurate documentation in Epic EHR, including care coordination notes and referral updates + Close discharge cases in Allscripts and… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... responsibilities.Able to operate and maintain department equipment. **Knowledge, Skills, and Abilities** + IV proficient. Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment… more
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