- Ventura County (Ventura, CA)
- …of quality, safety, and patient-centered care. The Quality Assurance (QA) and Utilization Review (UR) units ensure accurate and appropriate clinical ... Behavioral Health Quality Assurance Specialist Print...and Notices of Actions. This position continually collaborates with Utilization Review staff regarding chart/documentation reviews and… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …Respect Empowerment Sincerity Job Summary The UR Coordinator is responsible for the utilization review process at BBHH. Administrative and clerical functions of ... About Us Bakersfield Behavioral Healthcare Hospital, located in Bakersfield, California, is...at least 6 months of experience as a UR Specialist will apply. BBHH encourages all qualified candidates to… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management...Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM),… more
- LA Care Health Plan (Los Angeles, CA)
- …by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health ... Care Management Specialist II Job Category: Clinical Department: Care Management...the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and… more
- KBR (San Diego, CA)
- Title: Special Operations Cognitive Performance Specialist (Coronado, CA) THIS POSITION OFFERS RELOCATION. Belong. Connect. Grow. with KBR! KBR is a company of ... in individual and group settings, in specific cognitive, mental, behavioral , psychosocial, perceptual, learning, adaptive thinking, human engagements, and emotional… more
- Sutter Health (Santa Rosa, CA)
- …SSRRH-Sutter Santa Rosa Reg Hospital **Position Overview:** Substance and Behavioral Health Navigation **Job Description** : _These Principal Accountabilities, ... standardized and other ad hoc reports. * Conducts initial review and analysis of population lists/reports. * Works with...as directed by program policies. * Track and analyze utilization statistical data and presents to administration regularly or… more
- Providence (Santa Rosa, CA)
- …Group setting highly desirable. **Essential Functions:** + Assists in physician performance/ behavioral deficiencies as requested0 + Assists in formal Peer Review ... + Effectively obtains, interprets, and analysis physician information and utilization data. + Communicate regularly with referring physician regarding service;… more
- US Marine Corps (Twentynine Palms, CA)
- …organization functioning smoothly and effectively. Responsibilities Serves as the Clinical Specialist within the Behavioral Health program, Community Counseling ... policies, conducts screenings, clinical counseling services and case management services for Behavioral Health Branch programs. Serves as the first point of contact… more
- Cedars-Sinai (Los Angeles, CA)
- …Medical Directors of the CSMN, CSMN primary care physician leadership, CSMN specialist physician leadership, and executive leadership within the CSMN, including but ... conditions and MH disorders. + Provides regularly scheduled caseload reviews to behavioral health specialists. Caseload reviews focus primarily on patients who are… more
- The Cigna Group (Walnut Creek, CA)
- …This role strives to enhance employee consumerism and achieve customer-centric, utilization goals. Responsible for consulting with employers and brokers in the ... and procedures to routine instructions that require professional knowledge in specialist areas and provide standard professional advice and creation of initial… more
- HCA Healthcare (San Jose, CA)
- …at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical ... for assuring the safe, effective, evidence-based, and cost-effective selection and utilization of medications for the patients in which their team serves.… more