- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- Dignity Health (Bakersfield, CA)
- …particularly platforms like EZCAP or other systems used in utilization management preferred. - Experience working with clinical operations teams, including ... expected to work PST business hours.** **Position Summary:** The Utilization Management (UM) Trainer (Technical and Systems...and clinical data. 3. Documentation and Platform Utilization : - Train UM staff on the… more
- Ventura County (Ventura, CA)
- …as needed for outside services for patients/families; + Conducts daily clinical reviews for utilization /quality management activities based ... Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior Registered… more
- LA Care Health Plan (Los Angeles, CA)
- … Management Quality Reporting and Auditing Specialist I Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Quality Reporting and Auditing...In collaboration with leadership and trainers, provides education to staff based on results of audit findings, including but… more
- Sharp HealthCare (San Diego, CA)
- …will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM. ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
- Prime Healthcare (San Dimas, CA)
- …for the continuity of treatment. Coordinates discharge referrals as requested by clinical staff , fiscal intermediary, patients, and families. Performs other ... and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and… more
- Prime Healthcare (Inglewood, CA)
- …and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and … more
- Rady Children's Hospital San Diego (San Diego, CA)
- …the UM Operations Trainer's primary job function is to support Utilization Management operations by training non- clinical staff on how to successfully ... perform any non- clinical tasks. This includes, but is not limited to, initial authorization processing (data entry, eligibility verification, benefits verification, and requesting required supporting documents from submitting provider offices), answering… more
- Dignity Health (Rancho Cordova, CA)
- …CA region.** **Position Summary:** The Utilization Review (UR) LVN uses clinical judgement in providing utilization management (UM )services. The ... and diagnoses. - Strong knowledge nursing requirements in a clinical setting. Knowledge of utilization management...serve .We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge… more
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