- Prime Healthcare (Lynwood, CA)
- …(https://careers-primehealthcare.icims.com/jobs/163839/rn-case- manager utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the...Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience preferred.… more
- Providence (Mission Hills, CA)
- …concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required ... strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The… more
- LA Care Health Plan (Los Angeles, CA)
- …Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review . Monitors and oversees the collection and transfer of ... Utilization Management Nurse Specialist LVN II Job Category:...workplace environment. Perform prospective, concurrent, post-service and retrospective claim medical review processes. Utilizing considerable clinical judgement,… more
- LA Care Health Plan (Los Angeles, CA)
- …Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review . Monitors and oversees the collection and transfer of ... Utilization Management Nurse Specialist RN II Job Category:...setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with onsite staff, physicians, providers, member/family… more
- Pipeline Health System, LLC (Gardena, CA)
- … (CM) performs a wide variety of tasks and functions. These include utilization review , discharge planning, care coordination and variance management to assure ... with the multidisciplinary team including physicians and patients/families regarding utilization issues, documentation of medical necessity, discharge options,… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible for the centralized… more
- Fresenius Medical Center (Irwindale, CA)
- …address barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and ... quality improvement tools and electronic applications. + Performs desk review of facility Quality Assessment and Performance Improvement (QAPI) documentation… more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** The Manager , Clinical Operations Support is responsible for the daily oversight of the administrative and clinical operations of assigned ... support the mission and vision of Cedars-Sinai Health System and Cedars-Sinai Medical Care Foundation. Leads and consistently completes leader standard work with… more
- Universal Health Services (Palmdale, CA)
- …patient and his family. This person is the expert on issues related to utilization review and discharge planning. Qualifications Requirements: + Ability to read, ... Responsibilities Palmdale Regional Medical Center serves the region by providing high...and minimum of three years C linical C ase Management/ Utilization Review experience (preferred). Motivation for self-direction.… more
- Crane Aerospace & Electronics (Burbank, CA)
- **Program Manager - Landing Systems** Location **CA, Burbank** Department **Program Management** Employment Type **Full Time** **Crane Aerospace and Electronics** ... has an exciting opportunity fora **Program Manager III** at our **Burbank, CA** location. **About Crane:**...environments: from engines to landing gear; from satellites to medical implants and from missiles to unmanned aerial systems… more
- Crane Aerospace & Electronics (Burbank, CA)
- **Program Manager I - Landing Systems** Location **CA, Burbank** Department **Program Management** Employment Type **Full Time** **Crane Aerospace and Electronics** ... has an exciting opportunity fora **Program Manager I** at our **Burbank, CA** location. **About Crane:**...environments: from engines to landing gear; from satellites to medical implants and from missiles to unmanned aerial systems… more
- Ross Stores, Inc. (Los Angeles, CA)
- …and development for our teams\. **GENERAL PURPOSE:** The Area Loss Prevention Manager \(ALPM\) is responsible for protecting the assets of Ross Stores, Inc\. ... Operations, MPT, etc\.\) and analytics\. + Identify shortage risks through regular review of indicator reports; partner with stores to develop action plans to… more
- Illumination Foundation (Cerritos, CA)
- …Los Angeles County and the Inland Empire. Job Description The Outreach Lead Care Manager will review multiple Medi-Cal Managed Care Plan Member Information Files ... Manager will be accomplished in the form of time- utilization and will field high amounts of communications and...of Medi-Cal Managed Care Plan delivery systems Benefits + Medical Insurance funded up to 91% by Illumination Foundation… more
- LA Care Health Plan (Los Angeles, CA)
- …current and unrestricted California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager ... Manager , Enhanced Care Management (RN or LCSW) Job...ECM services to medically and behaviorally complex members. + Review systems and processes, making recommendations for improvement to… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Shared Services Program Manager II (Limited Duration- 12 months)) Job Category: Administrative, HR, Business Professionals Department: Claims Data and ... required to achieve that purpose. Job Summary The Enterprise Shared Services Program Manager II is responsible for leading and managing a portfolio of strategic and… more
- LA Care Health Plan (Los Angeles, CA)
- Portfolio Delivery Project Manager III Job Category: Information Technology Department: Enterprise Portfolio Management Office Location: Los Angeles, CA, US, 90017 ... the enterprise portfolio developed in support of LACs strategic direction. The Project Manager III, Portfolio Delivery (Project Manager III) is responsible for… more
- Parker Hannifin Corporation (North Hollywood, CA)
- Contracts Manager Location : NORTH HOLLYWOOD, CA, United States Job Family : Program Management Job Type : Regular Posted : Apr 3, 2024 Job ID : 46430 Back to Search ... at the operational site level. + This position reports to the General Manager and is responsible for the order management, contracts management, proposal management,… more
- Hologic (Los Angeles, CA)
- District Service Manager - California Los Angeles, CA, United States San Diego, CA, United States Here at Hologic, we are driven by our passion to become the global ... problem solving and innovation. We're seeking a highly skilled and experienced Service Manager to lead the California Field Service Team. This role is responsible… more
- Banc of California (Pasadena, CA)
- …and motivation to achieve branch excellence. Within their area, the Branch Manager is responsible for achieving superior financial results, including their own ... overall Bank and regulatory policies and guidelines. To accomplish this, the Branch Manager builds and develops a diverse and high performing branch team. Performs… more
- Universal Health Services (Rosemead, CA)
- …plans, interfacing with the treatment team/external case managers, authorizations, and utilization review with managed care organizations. This position provides ... Responsibilities Reasons Eating Disorder Center Reasons Residential Case Manager Are you caring, compassionate and hardworking? Apply today to join our amazing team!… more