- Prime Healthcare (Inglewood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/209416/ director -of- case - management utilization - ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities We are seeking a strategic and compassionate Director of Case Management to… more
- LA Care Health Plan (Los Angeles, CA)
- …of work/licensure. The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols, and ... of 7 years of acute/clinical care experience. Minimum of 2 years of experience in Case /Care/ Utilization Management in an acute care or health plan setting.… more
- LA Care Health Plan (Los Angeles, CA)
- …of varied RN clinical experience in an acute hospital setting. At least 2 years of Utilization Management / Case Management experience in a hospital or HMO ... Utilization Management Nurse Specialist RN II...Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims… more
- Dignity Health (Glendale, CA)
- …+ Five (5) years experience in utilization review and discharge planning, case management and managed care. Other qualifications: + Knowledge of the ... that 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
- 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
- Elevance Health (Los Angeles, CA)
- …Candidates must live in California. The **Medical Director ** will be responsible for utilization review case management for Medicare and Medicaid in the ... **Medical Director - Medicare and Medicaid** Location: This role enables...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Elevance Health (Los Angeles, CA)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Management ** **Outpatient Rehab Utilization Management ** **Virtual:** This role ... including radiology, cardiology and oncology._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the medical management staff… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- Summary The Associate Director , Patient Care Services/Nurse Executive provides direct oversight of Nursing, Social Work, Chaplain, Sterile Processing, and Patient ... decision-making on behalf of the public and staff. Develops resources utilization strategies to improve organizational performance. Mentors others in executive… more
- Bayer (Beverly Hills, CA)
- …minds to make a real difference, there's only one choice.** **Associate Director , Regional Marketing, Cardiovascular - California** **PURPOSE** As part of the ... incumbent will be responsible for activities across five key areas, in each case , acting as a champion to deliver brand communication strategy. 1. Strategic Thought… more
- Providence (Tarzana, CA)
- …in Healthcare related field (Acute, Ambulatory, Post-Acute, etc.) + 2 years Experience in Case Management (Care Coordination or Utilization Management ) ... care coordination along a continuum through effective transitional care management and utilization management . Recognizing...-by- case basis at each ministry by the Director of Care Management in consultation with… more
- Cedars-Sinai (Torrance, CA)
- …patient outcomes to upper management . + Collaborate closely with hospital-based case management to design systems, workflows, and protocols that ensure ... specific to the department(s) below: **Department Duties and Responsibilities** ** Utilization Management ** Maintain compliant UM processes that are… more
- Abbott (Los Angeles, CA)
- …This includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management ... Account Manager will work with, and report to, the Regional Sales Director to identify/evaluate market opportunities, business potential, and to achieve annual sales… 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
- 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
- UCLA Health (Los Angeles, CA)
- …Strong knowledge of social work services, and familiarity with evidenced based practices, case management , utilization review, discharge planning, home care, ... for complex clinical cases, working closely with the Clinical Director . They will be a resource for social work...or managed care + Strong knowledge of human resources management policies, with the ability to train, monitor, evaluate,… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …facilitation of groups. Employs evidence-based psychological treatment interventions and provides case management services as needed. Provides mental health ... manages clinical staff schedules, maintains compliance with routine audits of staff, utilization management , performance improvement, and other duties, as deemed… 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
- 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