- 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 (Chino, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/162220/case-management- manager utilization ... to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization ...to perform a holistic and comprehensive admission and concurrent review of the medical record for the… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/162306/case-management- manager utilization ... to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization ...to perform a holistic and comprehensive admission and concurrent review of the medical record for the… 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
- 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 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
- Fresenius Medical Center (Santa Paula, CA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Actalent (Ontario, CA)
- …provide telephonic case management *Certificates required: RN license The RN Case Manager Assistant is responsible to conduct medical necessity screening and ... integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention,… 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
- Universal Health Services (Corona, CA)
- …Program Manager , Wound Care This position is located at Corona Regional Medical Center in Corona, CA The Program Manager - Wound Care develops, ... implements and coordinates activities through interdisciplinary collaboration and utilization of wound care guidelines and practice standards. Maintains current… 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