- Daisy Co. (Alameda, CA)
- …services company, we're growing fast and are seeking aN orthern California Area Sales Director to support our NorCal branches. Why You'll Love This Role As an Area ... Sales Director at Daisy, you will oversee sales operations and...Develop and grow relationships with major local accounts. CRM Utilization : Achieve full CRM compliance across all area branches,… more
- Martin Luther King, Jr. Community Hospital (La Mirada, CA)
- …facilities and other types of community service providers as directed by the Director of Care Management . The Manager will assist with overseeing compliance ... Call on a rotation basis as assigned by the Director for Care Management ESSENTIAL DUTIES AND...violence prevention annually. Direct patient care or care coordination, utilization , case/disease management experience a plus Experience… more
- Martin Luther King, Jr. Community Hospital (La Mirada, CA)
- …apply online and send your resume to ###@mlkch.org. POSITION SUMMARY Reporting to the Director of Care Management , the Care Manager is responsible for managing ... AB1203 and other Federal or State regulatory agency requirements specific to Utilization Review and Discharge Planning. The Care Manager partners with the medical… more
- Flores Financial Services Inc (Santee, CA)
- Title: Accounting Manager Reports to: Director of Accounting Status: Salaried - Exempt Salary Range: $70,051.87 - 94,776.06 (aligned with company's pay band ... accurate and timely financial reporting packages for each client. Team Leadership & Management Lead, mentor and develop the AS team members, assign tasks, conduct… more
- VPET USA, LLC (Fontana, CA)
- …projects. The ideal candidate will be able to handle multiple projects through the utilization of time management and project management techniques. This ... Status: DOE FLSA: Non-Exempt Employment Type: Full-Time Location: Fontana, CA Reports to: Director of New Product Development Our team is currently seeking a Product… more
- CytomX Therapeutics, Inc. (South San Francisco, CA)
- …CA Candidate Location: Hybrid Travel Required: 5% Reports To: Sr. Director , Clinical Operations Department: Clinical Operations Position Type: Temporary (6-12 ... document review and tracking, vendor access and administration support, and finally utilization of an electronic Trial Master File (eTMF) and associated document … more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management… more
- Humana (Sacramento, CA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Sacramento, CA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Humana (Sacramento, CA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Ventura County (Ventura, CA)
- …and communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Utilization Management Admissions Liaison RN II...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Sharp HealthCare (San Diego, CA)
- …the direction of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
- LA Care Health Plan (Los Angeles, CA)
- …information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition… more
- Cognizant (Sacramento, CA)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' ... submit the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- The County of Los Angeles (Los Angeles, CA)
- NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Print ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3110377) Apply NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Salary $163,996.80… more
- Sharp HealthCare (San Diego, CA)
- …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective review Process. Performs ... + Participates in risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs, HEDIS reporting, site… more
- Alameda Health System (Oakland, CA)
- Director , Inpatient System Care Management + Oakland, CA + Highland General Hospital + SYS Care Coordination + Full Time - Varies + Management + Req ... Alameda Health System is hiring! Under the direction of the Vice President of Care Management , the Director of Inpatient System Care Management manages the… more
- Evolent (Sacramento, CA)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall...selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with… more
