- Sutter Health (Sacramento, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... services. The PA will develop expertise on matters regarding physician practice patterns, over- and under- utilization of...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print...Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48 Annually… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - ... 22, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN...observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that… more
- Dignity Health (Carmichael, CA)
- **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The ** Utilization Review RN** is responsible for the ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the...to be successful in the role:** + Understand how utilization management and case management … more
- Providence (Mission Hills, CA)
- **Description** RN - Utilization Review for our centralized Utilization Management team for Southern California. This position is Remote (Working from ... strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, and patient status determination. The… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Dignity Health (Glendale, CA)
- …perform the job. + Five (5) years experience in utilization review and discharge planning, case management and managed care. Other qualifications: ... are capitated to the Dignity Health hospitals (as well as participation in In-Network Utilization management ). in the GSSJSA and to provide support to the… more
- Providence (Napa, CA)
- …Per-Diem **Job Shift:** Day **Career Track:** Clinical Professional **Department:** 7810 UTILIZATION REVIEW **Address:** CA Napa 1000 Trancas St **Work ... Under minimal supervision and at the direction of the Case Management Director, the Inpatient Social Worker/Patient Counselor is responsible for assisting… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/176615/ utilization - review -nurse-lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... to new staff on system and referral processes. Assists physician offices and vendors with problem resolution. Knowledgeable in...Minimum two years of experience in acute hospital case management or equivalent. + Utilization Management… more
- Dignity Health (Bakersfield, CA)
- …as part of the regular schedule for this position.** **Position Summary:** The Utilization Management LVN is responsible for ensuring the integrity of the ... medical records, authorize requested services and prepare cases for physician review based on medical necessity. The...The position partners with both the Pre-Service and In-Patient Utilization Management teams. Ensures to monitor and… more
- The Cigna Group (Sacramento, CA)
- …Summary** Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate health care ... services in conjunction with the physician treatment plan. Handles more complex, high acuity cases,...facilitate appropriate healthcare outcomes for members. Ensures that case management program objectives are met by evaluating the effectiveness… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... become available.** VA offers a comprehensive total rewards package. VHA Physician Total Rewards. Recruitment Incentive (Sign-on Bonus): Authorized Education Debt… more
- Cedars-Sinai (CA)
- …Surgery is responsible to provide leadership, direction, and guidance to Physician Assistants and provide specialty collaborative patient management under ... a preceptor by mentoring PA's regarding care of defined populations in resource utilization and time management . + Demonstrate leadership as a clinical resource,… more
- Provider Solutions & Development (Burbank, CA)
- …of medical group management experience required * Must have working knowledge of utilization management and review essential to operations management ... with, motivate, and assist medical staff leadership to adhere to utilization management , clinical documentation, and other legal/regulatory requirements *… more
- Stanford Health Care (Palo Alto, CA)
- …is typically 4, 10 hour shifts **A Brief Overview** Provides supervision and management of advanced practice providers (APPs) in a distinct clinical service line. ... Provides clinical direction and education, works closely with operational and physician leaders, and has oversight of hiring, termination, and professional growth… more
- The County of Los Angeles (Los Angeles, CA)
- CHIEF PHYSICIAN II (VARIOUS SPECIALTIES) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2915002) CHIEF PHYSICIAN II (VARIOUS SPECIALTIES) ... American Specialty Board + Legible copy of California State Physician and Surgeon's Certificate authorized by the Board of...improve the level of care and service or the utilization of personnel. + Plans, directs and supervises medical… more
- The County of Los Angeles (Los Angeles, CA)
- CHIEF PHYSICIAN I (VARIOUS SPECIALTIES) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2914957) CHIEF PHYSICIAN I (VARIOUS SPECIALTIES) ... American Specialty Board. + Legible copy of California State Physician and Surgeon's Certificate authorized by the Board of...order to improve the level of service or the utilization of personnel. + Plans, directs and supervises medical… more
- STG International (Rancho Cucamonga, CA)
- …in quality improvement, care management , risk management , peer review , utilization review , clinical outcomes, and health enhancement activities. ... STGi is currently seeking a Primary Care Physician to provide services at our Community Based...Performance Improvement Team (QPIT) strategic initiatives. + Participate in review and improvement of clinical success in of areas… more
- Veterans Affairs, Veterans Health Administration (Fairfield, CA)
- …sections including, but not limited to, specialists, nursing staff, social services, utilization management , and other members of the interdisciplinary care team ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- The County of Los Angeles (Los Angeles, CA)
- CHIEF PHYSICIAN III Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2181189) Apply CHIEF PHYSICIAN III Salary $238,380.00 - $721,152.00 ... of the work with other organizational units and top management of the department. Assigns, trains, and evaluates medical...improve the level of care and service, or the utilization of personnel. Plans, directs and supervises medical research… more