- CenterWell (San Diego, CA)
- …available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...insurance and many other opportunities. **About Us** About CenterWell Home Health : CenterWell Home … more
- Veterans Affairs, Veterans Health Administration (Mather, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... 401K with up to 5% in contributions by VA Insurance: Federal health /vision/dental/term life/long-term care (many federal insurance programs can be carried into… more
- Ventura County (Ventura, CA)
- …+ Experience with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + At ... Behavioral Health Department, and the Ventura County Health Care Plan. VCMC is also home ...care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review … more
- Dignity Health (Rancho Cordova, CA)
- … Utilization experience required in health plan/UM operations, Acute or subacute utilization review . - Graduate of an accredited school of nursing. - BS ... a working knowledge of Utilization Management Working knowledge of the Utilization Management review processes, and regulatory requirements. Must have the… more
- Magellan Health Services (San Diego, CA)
- …assigned care support teams. Experience with Care Management flows. Knowledge of utilization management procedures, mental health and substance abuse community ... care plan, member education and care management. Conducts initial and concurrent review for prior authorization of higher levels of care against medical necessity… more
- Sutter Health (Emeryville, CA)
- …and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Some awareness ... organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA...Grouper (CMS) preferred. Post-acute levels of care such as Home Health , Hospice, Advance Illness Management (AIM),… more
- LA Care Health Plan (Los Angeles, CA)
- …as a health insurance environment and/or experience as care manager in home health or hospice environments. Previous care management experience to include ... and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required… more
- Dignity Health (Los Angeles, CA)
- …skills in diagnosis and assessment, case management, treatment planning, psychotherapy, and utilization review . **Qualifications** + One year's experience in an ... will be provided. The Clinician provides high quality outpatient mental health services and in- home counseling for children and their families in the form of… more
- Veterans Affairs, Veterans Health Administration (Long Beach, CA)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Former EDRP participants ineligible to apply. ... The Psychologist is part of Suicide Prevention National Telehealth Program in Tele-Mental Health within VISN 22 Consolidated Clinical Resource Hub (CRH). CRH is a… 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