- 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
- UCLA Health (Los Angeles, CA)
- …care with efficient resource utilization under the UCLA Medical Group Utilization Management guidelines. In this role, you will work collaboratively with ... Description Under the direction of the Assistant Director , the ICM Medicare Advantage Utilization ...RN License + Minimum of 2 years' experience in utilization management , Inpatient CM or clinical Experience.… more
- Select Medical (Los Angeles, CA)
- …A Joint Venture with Cedars, UCLA, and Select Medical Century City / Los Angeles, CA Director of Case Management - Full Time (on-site) **Salary Range: $150k ... hospitalization for their recovery. We are currently seeking a ** Director of Case Management -...growth of the Department including yet not limited to Utilization Review (UR) and resource management , discharge… 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
- 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
- Alameda Health System (Oakland, CA)
- …classification. + Accountable for Patient Care Coordination activities including system-wide Case Management , Care Coordination and Discharge Planning. + Aligns ... Director , Inpatient System Care Management + Oakland, CA +... Case Management with AHS strategic and operational objectives. + Optimizes efficient care … more
- Sharp HealthCare (San Diego, CA)
- …+ Participates in risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs, HEDIS reporting, ... findings in conjunction with the Quality Improvement Director . + Assists in POS/PPO Case Management and high-cost review with CMO and Claims management … more
- Sharp HealthCare (San Diego, CA)
- …performance-planning, competency and individual development planning process.Maintain current knowledge of case management , utilization management , and ... skills. **Required Qualifications** + 2 Years Recent acute care nursing experience, case management experience or equivalent experience in the healthcare… 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
- 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 , ... 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
- Genesis Healthcare (Elk Grove, CA)
- …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... Director of Rehab is responsible for assisting the Director of Rehab in the efficient management ...of therapy staff. 7. Assists in daily staffing and utilization in cooperation with input from treating therapists, consideration… 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
- Sharp HealthCare (San Diego, CA)
- …and retrospective rev1ew process. + Participates in risk management , pharmacy utilization management , catastrophic case review, outreach programs, HEDIS ... a managed care environment, preferably as an HMO Medical Director . + California Physicians and Surgeons License - Medical...the marketing effort, as requested. + Ensures that the Utilization Management staff is available on a… more
- Genesis Healthcare (Los Angeles, 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
- Genesis Healthcare (Carmichael, 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
- 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
- Dynatrace (Mountain View, CA)
- …+ Oversee the day-to-day operations of the support organization, ensuring efficient case management , timely resolution, and high customer satisfaction. + Drive ... **Your role at Dynatrace** The Director , Support Operations is responsible for leading and...and capacity planning to ensure optimal coverage and resource utilization . + Develop and execute a knowledge management… more
- Molina Healthcare (San Bernardino, CA)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more