- Sutter Health (Sacramento, CA)
- … care delays/issues as necessary; in collaboration with the Facility Acute Care Manager (CM). This position provides third-party payers clinical information ... SHSO-Sutter Health System Office-Valley **Position Overview:** This position facilitates utilization management (UM) processes to support that the right … more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created...net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II … more
- Elevance Health (Cerritos, CA)
- ** Utilization Management Representative II ** **Location:** Virtual: This role enables associates to work virtually full-time in **CALIFORNIA** , with the ... shift between 8 am - 5 pm PST. The ** Utilization Management Representative II ** is responsible for...to a nurse reviewer; and handles referrals for specialty care . + Processes incoming requests, collection of information needed… more
- LA Care Health Plan (Los Angeles, CA)
- Technical Applications Manager II Job Category: Information Technology Department: IT Solutions Delivery Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Technical Application Manager II reports to the Senior ...of HEDIS, HIE, Health Analytics required. Functional knowledge of Utilization Management, Care Management, Clinical Case Management,… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II Job...such as a health insurance environment and/or experience as care manager in home health or hospice ... support the safety net required to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist II is responsible for the management… more
- Sutter Health (Oakland, CA)
- … care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... to include the achievement of optimal health, access to care , and appropriate utilization of resources balanced...+ RN-Registered Nurse of California Required + Certified Case Manager (CCM) Preferred. **EXPERIENCE** + Minimum of 2 years… more
- Sutter Health (Modesto, CA)
- … care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... are to include the achievement of optimal health, access to care , and appropriate utilization of resources balanced with the patients' self -determination while… more
- The County of Los Angeles (Los Angeles, CA)
- MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply ... MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Salary...and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category:...such as a health insurance environment and/or experience as care manager in home health or hospice ... net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills...skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing… more
- Elevance Health (Los Angeles, CA)
- …different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II ** is responsible for care management within the ... **Telephonic Nurse Case Manager II ** **Sign on Bonus: $2000.**...claims or service issues. + Assists with development of utilization / care management policies and procedures. **Minimum Requirements:**… more