- Elevance Health (Walnut Creek, CA)
- …+ Determines the medical necessity of requests using clinical criteria. + Performs physician -level case review of musculoskeletal utilization requests. + ... PM Central** **Virtual:** This role enables associates to work virtually full -time, with the exception of required in-person training sessions, providing maximum… more
- The County of Los Angeles (Los Angeles, CA)
- …Salary $137,323.92 - $205,556.40 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5121T Department HEALTH SERVICES Opening Date 09/07/2017 + ... through university affiliations for interns, residents and fellows to train the physician workforce for tomorrow. THE MISSION: "To advance the health of our… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization, ... provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present educational… more
- Alameda Health System (San Leandro, CA)
- …staff, visitors, and volunteers. 8. Assures that the facility complies with all utilization review and case management requirements of Alameda County, AHS, and ... John George Psychiatric Hospital + Physicians JGP ER + Full Time - Day + Management + $96.70 -...Medical Director for John George Psychiatric Hospital by leading physician services specific to acute psychiatric care. 3. Liaison… 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 ... for the provider and more. This LVN is a full time Monday - Friday with no weekends or...direction and supervision of a registered nurse and/or licensed physician , and is accountable for the quality of nursing… more
- Veterans Affairs, Veterans Health Administration (Santa Rosa, CA)
- …Scopes of Practice: The Advanced MSA coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization ... at the next lower grade level. For all assignments above the full performance level, the higher-level duties must consist of significant scope, administrative… more
- Elevance Health (Costa Mesa, CA)
- …Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit** **Management/ Utilization ** ** Review ** **Virtual:** This role enables associates ... to work virtually full -time, with the exception of required in-person training sessions,...case reviews for their board certified specialty. + Makes physician to physician calls to gather medical… more
- Sutter Health (Santa Barbara, CA)
- …modifies and discontinues patient's drug therapy under the supervision of a physician in accordance with a collaborative practice agreement or an approved protocol. ... + Completes medication regimen review from a clinical, safety and cost perspective to...controlled substance management functions, analysis of use + Medication utilization data capture + Complex, high-cost, or hazardous drug… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... co-workers and hospital staff. The duties of this position vary widely requiring utilization of different processes and methods to accomplish this work. The work… more
- Alameda Health System (San Leandro, CA)
- …Psychiatry + San Leandro, CA + John George Psychiatric Hospital + Physicians JGP ER + Full Time - Day + Management + $142.34 - $237.23 / Hour + Req #:42466-31512 + ... OPPE, FPPE, and annual staff evaluations. 3. Participates in Medical Staff peer review processes in alignment with Just Culture principles in accordance with Medical… more