- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Homeless Programs Department. The duties and responsibilities are carried throughout the Health Care System Center including all clinical and other patient care… more
- Sharp HealthCare (San Diego, CA)
- …care setting, including ICU or intermediate care units, Medical-Surgical Nursing, and/or Home Health + 3 Years Medical Management experience, preferably in ... Health care related field **Other Qualification Requirements** + Utilization , Case Management, or Quality Management certification preferred. **Essential… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …team-based approach to healthcare. Oversee PACTs compliance to MyHealtheVet. Proficient in Tele- Health to home visits (VA Video Connect). Utilizing all available ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- VNA Health (Santa Barbara, CA)
- …and other team members in providing continuity of cared. + Supervise LVN's, Home Health Aides and Volunteers. + Ensure that arrangements for equipment ... nursing staff meetings. + Participate in Quality Management and Utilization Review Activities. + Maintain necessary records...Minimum one year acute care experience required; background in home health and/or hospice preferred. + Current… more
- Evolent (Sacramento, CA)
- …experience and as an RN - **Required** + Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies… more
- Humana (Sacramento, CA)
- …+ Previous experience in utilization management, case management, discharge planning and/or home health or rehab + Certification in Case Management (CCM) or ... part of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization...using clinical judgment and refers to internal stakeholders for review depending on case findings. + Educates providers on… more
- CVS Health (El Cerrito, CA)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... culture of continuous improvement, with the goal of changing health care for the better. **Position Summary:** At CVS...an essential pharmacist function + Ability to work in home store, and across the market in other locations,… more
- Banner Health (Susanville, CA)
- …management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission process ... experience. In accordance with State Pay Transparency Rules. Banner Health was named to Fortune's Most Innovative Companies in...LVN in the specialty area. Employees working for Banner Home Care AZ must possess an Arizona Fingerprint Clearance… more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team ... Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as needed. + Assists...+ Reviews hospital admissions information and enter/update inpatient, SNF, home health and DME referrals as needed.… more
- CVS Health (Sacramento, CA)
- At CVS Health , we're building a world of health...a Medical Director you will focus primarily on overseeing utilization review / quality assurance and be ... ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health ...care resources. **This is a remote based (work from home ) role preferably resides in Pacific Time Zone without… more