- The County of Los Angeles (Los Angeles, CA)
- …to a line operation responsible for the delivery of psychological rehabilitation, case management and/or Psychiatric Emergency Service of the Department of Mental ... team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable...to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions… more
- Elevance Health (Los Angeles, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
- Alameda Health System (Alameda, CA)
- …Minimum Data Set assessments and care plans as required by OBRA and PPS. 3. Assists Case Manager with the transfer of patients to other health care providers or ... and a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate of accredited… more
- YKK AP America Inc. (Rancho Cucamonga, CA)
- …this position is to Supervise all Fabrication operational personnel. Manage best utilization of labor to meet defined performance targets, quality standards, and ... assuring customer ship date commitments. Collaborate with Facility Operations Manager to evaluate Fabrication business conditions, special processing request, and… 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 ... with the interdisciplinary treatment team, coordinates patient care and provides case management for assigned patients. **Required Qualifications** + Master's Degree… more
- Deloitte (Costa Mesa, CA)
- …as general health and group benefits skills. Key Responsibilities + Lead project manager for specific projects or key workstream lead on larger projects. + Evaluate ... Pharmacy Benefit Manager (PBM) contracts, deal terms, and financial proposals. +...vendor selection, negotiation, and implementation. + Assist in the review and negotiation of premium rate/administrative fee renewals. +… more
- Molina Healthcare (Oakland, CA)
- …Licensed Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable ... Certified Clinical Coder + Certified Medical Audit Specialists (CMAS) + Certified Case Manager (CCM) + Certified Professional Healthcare Management (CPHM)… more
- The County of Los Angeles (Los Angeles, CA)
- …assigned to a line operation responsible for delivering psychological rehabilitation, case management, and/or psychiatric emergency services in the Department of ... team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable...to assaultive behavior or requiring more extensive monitoring and review of their condition and progress. Essential Job Functions… more
- Deloitte (Fresno, CA)
- …administration, proposal evaluation, vendor selection, negotiation, and implementation. + Review and negotiate premium rate/administrative fee renewals. + Evaluate ... by reviewing services, contracts, performance guarantees, and renewals. + Analyze claims utilization data and assess health plan performance against strategy. + Act… more