- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
- Ventura County (Ventura, CA)
- …the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining ... Doctor to coordinate and screen for the appropriateness of admissions and continued stays. This position makes recommendations to...No 03 Please detail your nursing experience with Case Management , Utilization Management , and discharge… more
- Sutter Health (Berkeley, CA)
- …systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area. Collaborates with ... of services and appropriate service reimbursement. Monitors and acts as a liaison between external payers, internal business office, admissions staff, and… more
- Pipeline Health System, LLC (East Los Angeles, CA)
- …nursing personnel and other professional staff to determine appropriate level of care, utilization of resources, length of stay and quality of care. + Assess ... insurance, governmental, and accrediting agency standards to determine criteria concerning admissions , treatment, and lengths of stay of patients. + Ensures that… more
- The Arora Group (Twentynine Palms, CA)
- …(WII) under the Psychological Health Transition to Care Initiative in the Case Management / Utilization Management Division at Naval Hospital 29 Palms . ... process, including assessment, planning, implementation, coordination, and monitoring. + Integrate case management (CM) with utilization management (UM) and… more
- Universal Health Services (Madera, CA)
- …assisting with establishing effective and timely payment plans, coordinating with utilization review and discharge planning efforts to limit risk of non-payment, ... of an intake inquiry form, verifies eligibility and benefits for all admissions . + Communicate benefits information and co-payments to patients and families prior… more
- Sharp HealthCare (San Diego, CA)
- …position, and employer business practices. **What You Will Do** To provide comprehensive utilization management and coordination of care for members who are ... contracted health plan requirements for documentation of concurrent SNF review and utilization management activities performed in a manner consistent with… more
- STG International (Lancaster, CA)
- …to ensure compliance and patient safety. + Participate in quality improvement, care management , risk management , peer review, utilization review, clinical ... with the veteran and assists in making referrals for services and/or admissions to the VAMC as medically appropriate. Determine which referrals are required… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …issues, monitor performance, and assists in problem resolution. Acts as a liaison between vendors and hospital departments to ensure accurate and timely charge ... role that requires 20-40% onsite. Healthcare experience with hospital billing, denials management , AR management , and supervisor experience is preferred. Epic… more
- Cedars-Sinai (Beverly Hills, CA)
- …+ As liaison coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... staff, insurance plans and other departments. + Actively participate in lean management processes by detailing, monitoring and updating department specific data. +… more
- Cedars-Sinai (CA)
- …+ As liaison coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... staff, insurance plans and other departments. + Actively participate in lean management processes by detailing, monitoring and updating department specific data. +… more
- Stanford Health Care (Palo Alto, CA)
- …screening/education of patients, intake, insurance verification, consult assignment, liaison with inpatient/outpatient providers, assisting and guiding patients and ... and psychiatry staff for patient and ECT service issues. + Utilization and review- Reviews prospectively, concurrently, and retrospectively for ECT patient's… more
- Sharp HealthCare (La Mesa, CA)
- …a health care system revenue cycle. + Previous social work or case management experience. + California Notary Public - California Secretary of State -PREFERRED ... COBRA, and Health Care Exchange Qualified Plan Enrollment.Identifies all unfunded admissions and completes face to face interview and application within 24… more