- 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 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening ... FTE:1 + Posted:July 14, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review...each individual in the classification. 1. Acts as a liaison between payers, billing, and medical staff by supplying… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Specialist + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Care ... FTE:1 + Posted:July 18, 2025 **Summary** **SUMMARY:** The System Utilization Management (SUM) Care Without Delay RN...each individual in the classification. 1. Acts as a liaison between payers, billing, and medical staff by supplying… more
- Sutter Health (Berkeley, CA)
- …systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area. Collaborates with ... of services and appropriate service reimbursement. Monitors and acts as a liaison between external payers, internal business office, admissions staff, and… more
- Ventura County (Ventura, CA)
- …medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. + Participates, as ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- Veterans Affairs, Veterans Health Administration (Martinez, CA)
- …Collaborate with the Admissions Coordinator to ensure safe and appropriate CLC admissions , maximize the utilization of CLC beds, and maintain transparency in ... are not limited to: Provide direct patient/resident care including comprehensive management of the physical, psychological, emotional, social, and spiritual needs of… more
- STG International (Corona, CA)
- …to ensure compliance and patient safety. *Participates in quality improvement, care management , risk management , peer review, utilization review, clinical ... with the veteran and assist in making referrals for services and/or admissions to the VAMC as medically appropriate. Determine which referrals are required… more
- Sutter Health (Tracy, CA)
- …STCH-Sutter Tracy Community Hosp **Position Overview:** Provides leadership and management support in planning, organizing, staffing and controlling the operational ... to direct facility operations, and supervises personnel in all departments when leadership/ management staff is not present in the facility. During that time, serves… more
- Cedars-Sinai (Santa Monica, CA)
- …+ As liaison coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... staff, insurance plans and other departments. + Actively participate in lean management processes by detailing, monitoring and updating department specific data. +… more
- Sharp HealthCare (San Diego, CA)
- …in a health care system revenue cycle. + Previous social work or case management experience. + California Notary Public - California Secretary of State - PREFERRED ... COBRA, and Health Care Exchange Qualified Plan Enrollment.Identifies all unfunded admissions and completes face to face interview and application within 24… more
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