- Emanate Health (Covina, CA)
- …the United States, and the #19 ranked company in the country. **Job Summary** The Manager Utilization Review / MediCal Specialist will develop and maintain ... of care from pre-admission through post-discharge for Medi-Cal patients. The Manager Utilization Review / MediCal Specialist will manage the program… more
- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most ... **Working Title** : CSMC 8750000 Utilization Management Utilization Review Case Manager FR...Manager FR 48010 Allen 429 1.00 **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical … more
- Prime Healthcare (Anaheim, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/157767/case- manager utilization ... outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- LA Care Health Plan (Los Angeles, CA)
- …Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review . Monitors and oversees the collection and transfer of ... Utilization Management Nurse Specialist LVN II Job Category:...workplace environment. Perform prospective, concurrent, post-service and retrospective claim medical review processes. Utilizing considerable clinical judgement,… more
- LA Care Health Plan (Los Angeles, CA)
- …Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review . Monitors and oversees the collection and transfer of ... Utilization Management Nurse Specialist RN II Job Category:...setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with onsite staff, physicians, providers, member/family… more
- UCLA Health (Los Angeles, CA)
- …federal laws/regulations. You will extrapolate and summarize essential information for the UM Manager and Medical Director and regularly meet with them for ... contact for receiving and resolving member denials. You will review denials for accuracy, confirming the receipt of necessary...MSO, IPA, or health plan) + In-depth knowledge of medical terminology + Understanding of the HMO referral process,… more
- LA Care Health Plan (Los Angeles, CA)
- …Practitioner (NP)- Active, current and unrestricted California License Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) ... Manager , Delegation Oversight Clinical Audit Job Category: Clinical...with the Director, Delegation Oversight Audit on clinical issues/clinical review and interfacing with external agencies including other Local… more
- Pipeline Health System, LLC (Gardena, CA)
- … (CM) performs a wide variety of tasks and functions. These include utilization review , discharge planning, care coordination and variance management to assure ... with the multidisciplinary team including physicians and patients/families regarding utilization issues, documentation of medical necessity, discharge options,… more
- LA Care Health Plan (Los Angeles, CA)
- Manager , Customer Solution Center Appeals and Grievances Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Manager , Customer Solution Center Appeals and Grievances is responsible for the centralized… more
- Fresenius Medical Center (Irwindale, CA)
- …address barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and ... quality improvement tools and electronic applications. + Performs desk review of facility Quality Assessment and Performance Improvement (QAPI) documentation… more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** The Manager , Clinical Operations Support is responsible for the daily oversight of the administrative and clinical operations of assigned ... support the mission and vision of Cedars-Sinai Health System and Cedars-Sinai Medical Care Foundation. Leads and consistently completes leader standard work with… more
- Universal Health Services (Palmdale, CA)
- …patient and his family. This person is the expert on issues related to utilization review and discharge planning. Qualifications Requirements: + Ability to read, ... Responsibilities Palmdale Regional Medical Center serves the region by providing high...and minimum of three years C linical C ase Management/ Utilization Review experience (preferred). Motivation for self-direction.… more
- Walmart (Los Angeles, CA)
- Position Summary What you'll do **Production & Resourcing Senior Manager ** Walmart Creative Studio (WCS) is the in-house creative agency for Walmart. Our team ... live better. **Position Summary** The Production Operations and Resourcing manager is a Senior Manager position. This...implement universal intake form for IP. * Run monthly utilization reports and forecasts. * Work with the facilities… more
- City of Long Beach (Long Beach, CA)
- FLEET SERVICES BUREAU MANAGER Print (https://www.governmentjobs.com/careers/longbeach/jobs/newprint/4456802) FLEET SERVICES BUREAU MANAGER Salary $140,000.00 - ... officials are elected to staggered four-year terms. The City Council appoints the City Manager , City Clerk, and Police Oversight Director. The City Manager is… more
- Crane Aerospace & Electronics (Burbank, CA)
- **Program Manager II - Cabin Systems** Location **CA, Burbank** Department **Program Management** Employment Type **Full Time** **Job Brief** This position is ... to be provided after hire. **Crane Aerospace & Electronics** is seeking a **Program Manager II - Cabin Systems** to join our **Burbank, CA** campus. **Job Summary:**… more
- Crane Aerospace & Electronics (Burbank, CA)
- **Program Manager - Landing Systems** Location **CA, Burbank** Department **Program Management** Employment Type **Full Time** **Job Brief** This position is ... be provided after hire. **Crane Aerospace & Electronics** is seeking a **Program Manager III** to join our **Burbank, CA** campus. **Job Summary:** Program Managers… more
- Ross Stores, Inc. (Los Angeles, CA)
- …and development for our teams\. **GENERAL PURPOSE:** The Area Loss Prevention Manager \(ALPM\) is responsible for protecting the assets of Ross Stores, Inc\. ... Operations, MPT, etc\.\) and analytics\. + Identify shortage risks through regular review of indicator reports; partner with stores to develop action plans to… more
- LA Care Health Plan (Los Angeles, CA)
- …current and unrestricted California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager ... Manager , Enhanced Care Management (RN or LCSW) Job...ECM services to medically and behaviorally complex members. + Review systems and processes, making recommendations for improvement to… more
- Illumination Foundation (Cerritos, CA)
- …Los Angeles County and the Inland Empire. Job Description The Outreach Lead Care Manager will review multiple Medi-Cal Managed Care Plan Member Information Files ... Manager will be accomplished in the form of time- utilization and will field high amounts of communications and...of Medi-Cal Managed Care Plan delivery systems Benefits + Medical Insurance funded up to 91% by Illumination Foundation… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Shared Services Program Manager II (Limited Duration- 12 months)) Job Category: Administrative, HR, Business Professionals Department: Claims Data and ... required to achieve that purpose. Job Summary The Enterprise Shared Services Program Manager II is responsible for leading and managing a portfolio of strategic and… more