- Prime Healthcare (Inglewood, CA)
- …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization … 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 ... and determinations within required turnaround times specific to the case type. Identifies requests needing medical director ...setting. Previous experience to have a strong understanding of Utilization Management / Case Management … more
- LA Care Health Plan (Los Angeles, CA)
- …of work/licensure. The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols, and ... of 7 years of acute/clinical care experience. Minimum of 2 years of experience in Case /Care/ Utilization Management in an acute care or health plan setting.… more
- Providence (Torrance, CA)
- **Description** Under the supervision of Regional Director of Care Management , the Utilization Management Coordinator is responsible for providing ... months (180 days) of hire. + 3 years EPIC Case Management and ADT Patient Access. **Why...Multiple shifts available **Career Track:** Admin Support **Department:** 7000 UTILIZATION MGMT CA SOCAL **Address:** CA Torrance 4180 W… more
- Genesis Healthcare (Los Angeles, CA)
- …care management goals. 9. Works collaboratively with the Director or Sr. Director of Case Management to update strategic business plan and ensure ... In conjunction with the Director or Sr. Director , acts as case management ...of clinical nursing experience is required. Prior experience in utilization review, case management or… more
- Sharp HealthCare (La Mesa, CA)
- …performance planning, competency and individual development planning process.Maintain current knowledge of case management , utilization management , and ... outcomes. **Required Qualifications** + 3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse (RN) - CA Board… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of… more
- UCLA Health (Los Angeles, CA)
- …delivery for MSO members. + Ensure seamless integration of various clinical functions with Utilization Management , such as Case Management , Quality ... Description We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation,...programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
- Humana (Sacramento, CA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants..., depending on the line of business. The Medical Director conducts Utilization Management or… more
- CenterWell (Sacramento, CA)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... prior experienceparticipatingin teams focusing on transitions of care, quality management ,utilizationmanagement, case management , discharge planning and/or… more
- Sharp HealthCare (San Diego, CA)
- …performance-planning, competency and individual development planning process.Maintain current knowledge of case management , utilization management , and ... Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Bachelor's Degree in Nursing; Master's Degree… more
- The County of Los Angeles (Los Angeles, CA)
- …the following: + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT ... appropriateness of the level of care. For this examination, Case Management is a collaborative process that...vacancy in Department of Health Services, Harbor-UCLA Medical Center, Utilization Management Division. May also be used… more
- Genesis Healthcare (Willows, CA)
- …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... The Director of Rehab is responsible for the efficient management of rehabilitation services in their assigned account(s). This position also assists… more
- Genesis Healthcare (Hayward, CA)
- …of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification ... Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and… more
- Evolent (Sacramento, CA)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- University of Southern California (Los Angeles, CA)
- …populations. The RN case manager role integrates the functions of utilization management , quality management , discharge planning assessment, and ... Participates in InterQual competency testing as requested by department director . + Outcomes Management * Participates in...Qualifications: + Pref Bachelor's degree + Pref 1 year Case management or utilization review… more
- University of Southern California (Alhambra, CA)
- … of specific patient populations. The role integrates the functions of complex case management , utilization management , quality management ... as requested by department director or Medical Director . + Outcomes Management 1. Participates in...5 years Clinical experience + Req 2 years Ambulatory case management or utilization review… more
- Highmark Health (Sacramento, CA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more