- Genesis Healthcare (Carmichael, CA)
- …help older adults stay active and thrive while providing essential therapy for children at home and in school. With over 38 years of trusted service, our reach spans ... nursing centers, assisted and independent living facilities, outpatient clinics, and home -based care. We're proud to deliver personalized care exactly where and… more
- Sharp HealthCare (San Diego, CA)
- …when not in use.Is knowledgeable of current laws and regulations regarding Utilization Review and Discharge Planning.Morning arrival time insures orderly ... + Data collectionParticipates in data and statistics collection as requested by Utilization Review , Service Line and Quality Improvement Committees. + Denial… more
- CenterWell (Sacramento, CA)
- …+ Monitor plan performance and proactively bring issues to the forefront for review + Support new business implementations with a goal of ensuring all pharmacy ... and present to client + Escalate issues for immediate review and action whenever necessary + Request, review...internal partners and the Medicaid market to manage pharmacy utilization and spend + Manage escalated member, client and… more
- BrightView (Santa Ana, CA)
- …provides direct support to branch leadership to drive optimal equipment utilization , vendor performance, and compliance with company standards. You'd be responsible ... increase rebate flow-through, and reduce capital expenditures. 3) Operational Support & Utilization + Analyze equipment utilization across branches to identify… more
- Humana (Sacramento, CA)
- …with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health ... health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review … more
- Providence (Santa Rosa, CA)
- …with management, medical staff and medical center personnel. Provides payor/ utilization review organizations with concurrent retrospective utilization ... staff, medical center personnel and outside resources to ensure the appropriate utilization of resources according to clinical and financial standards. Monitors the… more
- Ventura County (Ventura, CA)
- …that establish, expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities ... + Travels to meet and engage with patients at home and in the community to build trust and...such as utilization review , monitoring and evaluation procedures, and… more
- Broadcom (Palo Alto, CA)
- …and risk mitigation strategies. Key Responsibilities: License Agreement Analysis: . Review and analyze customer software license agreements to understand terms, ... Audits: . Deeply understand VMware software usage and license utilization across the organization's infrastructure, including on-premises and cloud environments.… more
- Humana (Sacramento, CA)
- …with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health ... health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review … more
- Dignity Health (Bakersfield, CA)
- **Responsibilities** This position is work from home ** **within California** **.** Please note: Rotating holidays and weekends will be expected as part of the ... regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the adverse determination… more