- LA Care Health Plan (Los Angeles, CA)
- …regulatory requirements. + Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization , level of care and length of stay criteria ... Registered Nurse (RN) Manager , Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances Location: Los… more
- Sharp HealthCare (San Diego, CA)
- …referrals for care and services are directed to appropriate network providers, and obtains prior authorization for in network and out of network services as ... Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) -...document and initiate discharge plan including early referrals and authorization for LTAC, SNF, Rehab, homecare, DME and infusion… more
- Sharp HealthCare (San Diego, CA)
- …referrals for care and services are directed to appropriate network providers, and obtains prior authorization for in network and out of network services as ... Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) -...document and initiate discharge plan including early referrals and authorization for LTAC, SNF, Rehab, homecare, DME and infusion… more
- University of Southern California (Alhambra, CA)
- In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an ... As more complex medical treatment options emerge the Case Manager will look to eliminate gaps in the care...the appropriate patient status is assigned upon admission and prior to discharge; InterQual or MCG reviews are completed… more
- Medtronic (Irvine, CA)
- …compassionate world. **A Day in the Life** Medtronic is seeking a Clinical Territory Manager (CTM) to support the education and training of the company's products to ... company and are field clinical diabetes experts. CTMs report to the Clinical District Manager aligned to their specific district. This is a field based position that… more
- Stanford Health Care (Palo Alto, CA)
- …ASA + Knowledge of medical management statistics relating to UM/CM and prior authorization process management. + Extensive knowledge of risk stratification ... for improvement. **Licenses and Certifications** + Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure ....Compact State Licensure . + CCM - Certified Case Manager preferred . **These principles apply to ALL employees:**… more
- Sharp HealthCare (La Mesa, CA)
- …referrals for care and services are directed to appropriate network providers, and obtains prior authorization for in network and out of network services as ... Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) -...document and initiate discharge plan including early referrals and authorization for LTAC, SNF, Rehab, homecare, DME and infusion… more
- The County of Los Angeles (Los Angeles, CA)
- …response team. + Assists Psychiatrists in completing and checking for accuracy on Treatment Authorization Request (TAR) and Prior Authorization (PA) forms. + ... service are met and is subject to closure without prior notice. TYPE OF RECRUITMENT Open Competitive Job Opportunity...team leaders reporting to a mental health clinical program manager or a physician manager . Positions allocable… more
- US Tech Solutions (San Francisco, CA)
- **Job Summary** Under the supervision of the Patient Access Services Manager , the Senior Admitting Worker (SAW) is generally assigned a primary work unit but may ... escort upon arrival for services and/or after triage by the nurse . The registration process includes gathering demographic, financial information and entering… more
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