- Prime Healthcare (Inglewood, CA)
- …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization … more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... and determinations within required turnaround times specific to the case type. Identifies requests needing medical director ...setting. Previous experience to have a strong understanding of Utilization Management / Case Management … more
- UCLA Health (Los Angeles, CA)
- …delivery for MSO members. + Ensure seamless integration of various clinical functions with Utilization Management , such as Case Management , Quality ... Description We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation,...programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group… more
- The County of Los Angeles (Los Angeles, CA)
- …the following: + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT ... appropriateness of the level of care. For this examination, Case Management is a collaborative process that...vacancy in Department of Health Services, Harbor-UCLA Medical Center, Utilization Management Division. May also be used… more
- Genesis Healthcare (Los Angeles, CA)
- …of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification ... Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and… more
- Molina Healthcare (Los Angeles, CA)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Elevance Health (Los Angeles, CA)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... **Behavioral Health Medical Director -Psychiatrist Appeals** **Location:** California. This role enables associates...aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- UCLA Health (Los Angeles, CA)
- …working within a health plan, required + Knowledge of Medicare Advantage experience with utilization management , quality improvement, or case management , ... + Contribute to interdisciplinary care team rounds for complex case management . + Serve as clinical SME...required + Minimum of 2 years of experience in Utilization Management , required + Minimum of 2… more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary ... and receives clinical supervision as needed from the Medical Director of Care Management . The position is...care with internal LA Care departments such as Care Management (CM), Utilization Management (UM),… more
- Cedars-Sinai (Beverly Hills, CA)
- …to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the ... The Case Manager is responsible for the case management of patient while hospitalized and...date of discharge. + Communicates regularly with CSMPN Medical Director , Employee Health Services, Risk Management , and… more
- ICW Group (Woodland Hills, CA)
- … case management and utilization review. + Works closely with Case Management Manager and Director to perform quarterly reporting on program ... AND SKILLS** Understanding of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review, Telephonic Nurse Case Management , and… more
- Cedars-Sinai (Beverly Hills, CA)
- …Research Operations is accountable to the Department Chair and/or Institute Executive Director and serves as the primary source of information for the department. ... Investigators (PIs), staff and students to provide analytical support and project management in fulfilling the established goals and objectives for the department… more
- Providence (Tarzana, CA)
- …Healthcare related field (Acute, Ambulatory, Post-Acute, etc.) + 2 years of Experience in Case Management (Care Coordination or Utilization Management ) ... -by- case basis at each ministry by the Director of Care Management in consultation with...or Healthcare related field. + Upon hire: Certification in Case Management (ACM or CCM). **Why Join… more
- LA Care Health Plan (Los Angeles, CA)
- …information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA,...dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all… more
- UCLA Health (Los Angeles, CA)
- …The Home Health ICM Coordinator plays a key role in supporting our Utilization Management team to ensure safe, high-quality, and cost-effective care for ... patients enrolled in UCLA Medicare Advantage and Intensive Case Management programs. Under the supervision of the RN Assistant Director , you will coordinate… more
- The County of Los Angeles (Los Angeles, CA)
- …to a line operation responsible for the delivery of psychological rehabilitation, case management and/or Psychiatric Emergency Service of the Department of ... resources. + Provides consultation to community agencies in the utilization of mental health and support services provided by...caseload of clients and facilitate routine follow up and case management services as needed. + Works… more
- The County of Los Angeles (Los Angeles, CA)
- …swabs, etc.) + Maintains a caseload of clients and facilitate routine follow up and case management services as needed. + Works in conjunction with other team ... to community resources. + Provides consultation to community agencies in the utilization of mental health and support services provided by directly operated clinics,… more
- The County of Los Angeles (Los Angeles, CA)
- …assigned to a line operation responsible for delivering psychological rehabilitation, case management , and/or psychiatric emergency services in the Department ... and significant others. + Provides consultation to community agencies on the utilization of mental health and support services provided by department-owned clinics,… more
- WelbeHealth (Los Angeles, CA)
- …interdisciplinary team (IDT). The Travel RN Specialist covers any nursing roles (eg, RN Case Manager, RN Clinic Nurse) as needed in multiple markets. The Travel RN ... of care, participant satisfaction, and to prevent unfavorable outcomes, inappropriate utilization of resources, and unnecessary hospitalizations + Act as the point… more