- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and to ensure… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all… more
- ABM Industries (Mountain View, CA)
- …various individuals and organizations, including: * Corporate Real Estate to review and resolve planning forecast requirements, concerns, and issues, * Business ... gather top-down headcount and growth projections, * Project management to review planning strategies that drive construction projects and support the implementation… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- The County of Los Angeles (Los Angeles, CA)
- …NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care, Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug Information, ... NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care, Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug Information,… more
- Sutter Health (Sacramento, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of ... care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely… more
- UCLA Health (Santa Monica, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... teams + Knowledge of a large university teaching hospitals Preferred: Strong Utilization Review experience and understanding of CMS and other regulatory… more
- Sutter Health (Modesto, CA)
- …and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of ... care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely… more
- Highmark Health (Sacramento, CA)
- …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... units that may assist in the resolution of issues or problems. + Access, review , utilize, contribute content to and participate in the maintenance of the shared… more