- The Oncology Institute of Hope and Innovation (Cerritos, CA)
- …in 75+ clinic locations and growing. TOI is changing oncology for the better. Utilization Management Medical Director Oncology Work Location: REMOTE ... all clinical decisions. Participate in the development and continuous improvement of utilization management protocols and criteria specific to oncology. Review… more
- NORTH EAST MEDICAL SERVICES (San Francisco, CA)
- …CA Salary Range $285229.20 - $332260.24 Salary Description The PACE Medical Director is responsible for the management and oversight of the physicians, ... and other staff assigned to his/her team. The PACE Medical Director oversees the clinical care provided...industry and professional standards of healthcare, utilization management , quality improvement, and other medical … more
- South Central Family Health Center (Los Angeles, CA)
- …goals. Act as a liaison on behalf of the COO with the Chief Medical Officer, Clinical Director , Clinic Managers, and Facilities Provides department and ... Title: Clinic Operations Director Base Salary Range : $120,000 - $140,000...equipment, medical terminology, customer service, and some medical billing experience. Excellent negotiation and project management… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- …services, WIC support, mental health counseling, community health education, and more! The Medical Director , Family Medicine is an essential member of the TVHC ... the Chief Medical Officer (CMO), the Associate Medical Director is responsible for the day-to-day...and the ongoing clinic operations of TVHC. Collaborates with Management Team members, as directed, to develop strategies and… more
- University of California San Francisco (San Francisco, CA)
- …clinical care and operations within SMHW. They develop, implement, and monitor medical management policies and procedures while leading quality assurance, ... use of technology in the clinical setting and oversees utilization management to ensure accessibility and quality...to ensure accessibility and quality of care. The Executive Director leads financial management , budgeting, and strategic… more
- PACS (Clovis, CA)
- …referral. If unable to complete evaluation in 24 hours, documentation in medical record clearly defines cause for delay. Develop effective treatment plan and ... patient progress, problem and plans. Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Participate in in… more
- Cedars Sinai (Beverly Hills, CA)
- …review process. The coordinator works collaboratively with all team members of Utilization Management , Patient and Provider Services, Claims Department and other ... eligibility before processing authorizations. Contacts facilities identified by the UM Nurses/Manager/ Director / Medical Director to research any issues (ie… more
- AHMC Healthcare (San Gabriel, CA)
- …of Case Management , Risk Management , Director of Quality Management and the Vice President of Medical Affairs. Participates in committee meetings, ... complex patients under the age of 65 to the MediCal Case Management program. Facilitates transfer of...experience in a critical care setting (preferred) Two years Utilization Management /Case Management experience in… more
- COPE Health Solutions (Sacramento, CA)
- …optimized deployment of an administrative case management tracking system/care management documentation Reports to the Director of Operations Performs ... Description The Enhanced Care Management (ECM) Program Manager, provides leadership and direction...Status Exempt Salary Range $68,000 - $75,000 Reports To Director of Operations Direct Reports Community Health Workers &… more
- Adventist Health (Montebello, CA)
- …healthcare to the community. We are comprised of a 192-bed hospital, wound care medical office and surgical and laboratory services. The greater Los Angeles area is ... Summary: Provides unit-based leadership working collaboratively with the Nurse Manager, Director , Physicians, and staff. Supervises and directs the activities of… more
- Cedars Sinai (Los Angeles, CA)
- …the safe and effective delivery of patient care services in the Cedars-Sinai Medical Care Foundation. Is responsible for daily operations of the clinical operations ... and leads department using shared governance model and Lean principles of management . Uses expert knowledge, clinical skills and critical thinking in managing daily… more
- Phoenix House California (Santa Ana, CA)
- …Clinical Director , the Admissions Manager is responsible for the management of the administrative and clinical functions for the Admissions Departments at ... and appropriateness of treatment and admission. Provides Quality Assurance and Utilization Review to ensure documentation meets DHCS standards, ensures the timely… more
- Heritage Sierra Medical Group (Valencia, CA)
- …and family to coordinate care during and after discharge. Acquire approval from HSMG Medical Director for any and all transfers including higher level of care, ... Founded in 1984, Heritage Sierra Medical Group offers technology-driven patient care with the...and facilitating those transfers. Charting and utilization review of those patients currently admitted. Perform other… more
- Mission Neighborhood Health Center (San Francisco, CA)
- …reducing obstacles to obtaining essential services. Assist patients in completing civic and medical forms. Increase utilization of Teen Clinic and other MNHC ... Health Case Manager role This position reports to the Director of Behavioral Health and Substance Use Counseling and...Counseling, the Case Manager performs screenings and short-term case management tasks for patients in the Prenatal Clinic, Adult… more
- UnitedHealth Group (Santa Barbara, CA)
- …accurate and up to date information to the H&C Transitions Sr. Manager or Medical Director Assure appropriate referrals are made to the Health Plan, High-Risk ... (as indicated) according to CMS criteria When H&C Transitions is delegated for utilization management , review referral requests that cannot be approved for… more
- UnitedHealth Group (Cypress, CA)
- …Plan benefits Review and interpret Plan language Coordinate reviews with the Medical Director Utilize clinical guidelines and criteria Accurately documenting ... years of experience using MCG and/or Medicare criteria 1+ years of Utilization Management , pre-authorization, concurrent review or appeals experience Appeals… more
- University of Southern California (Arcadia, CA)
- Manages all clinical operations under the direction of the Director . Manages clinical and administrative responsibilities of the office, including directing the work ... of clinical supervisors, administrative and medical staff of the department/clinic. Oversees operations of patient care programs. Directs nursing practice,… more
- Flores Financial Services Inc (Santee, CA)
- Title: Accounting Manager Reports to: Director of Accounting Status: Salaried-Exempt Pay Range: $70,051.87-$94,776.06 (aligned with company's pay band structure) ... Benefits: Medical , Dental, Vision, SIMPLE IRA (3% employer match) Flexible...processing and overall customer satisfaction. Key Responsibilities Client Relationship Management Serve as the primary AS contact for assigned… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- Under the direction of the Director of Population Health, the Housing Navigator will provide Housing Transition Navigation (HN) services to consumers experiencing ... homelessness to support obtaining permanent housing reducing utilization of crisis and inpatient health care resources among those receiving services. By providing… 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 an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
