- Humana (Sacramento, CA)
- …and help us put health first** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical necessity ... required. Mandatory overtime during peak season.** **Job Description:** The Staff Utilization Management Pharmacist (VSP/PT)...**Job Description:** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional… 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
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… 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
- Cedars-Sinai (Beverly Hills, CA)
- …Epic Tapestry workflows. Preferred specialty experience in UM - Utilization Management and/or Benefits build/implementation. Ability to balance ... or related field. (preferred) Epic Tapestry Certification required. (UM - Utilization Management and/or Benefits certification highly preferred) \#LI-Remote… more
- Sharp HealthCare (San Diego, CA)
- …procedures. + Plan of careWorks collaboratively with the Hospitalist Team and Case Management staff to ensure smooth transitions throughout the continuum of ... rounds, as required, to discuss high risk patients requiring case management follow up.Attends clinical in-services or required operational/ clinical… more
- Sedgwick (Sacramento, CA)
- …to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment. **ARE YOU AN IDEAL CANDIDATE?** We are ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign ...+ Enters demographics and UR information into claims or clinical management system; maintains data integrity. +… more
- Provider Solutions & Development (Torrance, CA)
- …with, motivate, and assist medical staff leadership to adhere to utilization management , clinical documentation, and other legal/regulatory requirements ... between the medical center and its physicians to improve clinical quality, resource utilization and increase value... experience required + Must have working knowledge of utilization management and review essential to operations… more
- Provider Solutions & Development (Mission Hills, CA)
- …with, motivate, and assist medical staff leadership to adhere to utilization management , clinical documentation, and other legal/regulatory requirements ... between the medical center and its physicians to improve clinical quality, resource utilization and increase value... experience required + Must have working knowledge of utilization management and review essential to operations… more
- Stanford Health Care (Palo Alto, CA)
- …or improving patient care quality. The specialist collaborates with physicians, clinical staff , and administrative leaders to standardize products, streamline ... applicable. + Lead strategic product conversations with physicians and clinical staff to standardize practices and shift...care and academic medical centers that may impact product/service utilization or Value Based Management processes. +… more