- 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 ... meet service standards. Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.Able to respond to changing… 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 ... meet service standards. Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.Able to respond to changing… more
- UCLA Health (Los Angeles, 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 ... CA RN License and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three years of acute hospital… more
- CVS Health (Sacramento, CA)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Evolent (Sacramento, CA)
- …to adeptly negotiate internally and externally around interpretation and application of utilization review law, accreditation standards and policy. + Ensures ... **What You Will Be Doing:** + Responsible for oversight of utilization management (UM)/care management (CM) correspondence development, internal and external… more
- Alameda Health System (San Leandro, CA)
- …preferred. Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or ... resource Management issues; other issues including concerns involving under/over utilization , avoidable days and quality issues. Coordinate daily with… more
- HCA Healthcare (Riverside, CA)
- …Nurse (RN) with current California license required, Case Management Certification or utilization review preferred + Associate's Degree minimum required + ... Bachelor's Degree preferred + Three years of experience in clinical nursing required. Two years experience in case management. + InterQual experience preferred Riverside Community Hospital is a large acute care facility with 517 beds, established in 1901. It… more
- The County of Los Angeles (Los Angeles, CA)
- …NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care, Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug Information, ... by assisting in the establishment of criteria for cost effectiveness/control utilization use, process indicators, and monitoring parameters; conducts evaluations to… more
- Emanate Health (West Covina, CA)
- …for performing clinical consults according to pharmacy guidelines and conducting ongoing drug utilization review to promote effective, safe and efficient use of ... medications. Supervises technicians to optimize workflow and resource utilization . Actively participates in CQI activities. **Job Requirements** **Minimum Education… more
- Dignity Health (Arnold, CA)
- …services provided; participate in annual review of patient health records and utilization review studies of the Clinic services + Maintain confidentiality of ... records are transferred as required when patients are referred; participate in an annual review for quality completeness + Is present in the Clinic at least once… more