- 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 (Lynwood, CA)
- …(https://careers-primehealthcare.icims.com/jobs/163839/rn-case- manager utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the...Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience preferred.… 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
- 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
- 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
- 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
- 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)
- …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
- 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
- LA Care Health Plan (Los Angeles, CA)
- Portfolio Delivery Project Manager III Job Category: Information Technology Department: Enterprise Portfolio Management Office Location: Los Angeles, CA, US, 90017 ... the enterprise portfolio developed in support of LACs strategic direction. The Project Manager III, Portfolio Delivery (Project Manager III) is responsible for… more
- Parker Hannifin Corporation (North Hollywood, CA)
- Contracts Manager Location : NORTH HOLLYWOOD, CA, United States Job Family : Program Management Job Type : Regular Posted : Apr 3, 2024 Job ID : 46430 Back to Search ... at the operational site level. + This position reports to the General Manager and is responsible for the order management, contracts management, proposal management,… more
- CBRE (Culver City, CA)
- Real Estate Manager Job ID 167477 Posted 15-May-2024 Service line Advisory Segment Role type Full-time Areas of Interest Property Management Location(s) Culver City ... America About the role As a CBRE Real Estate Manager , you will lead all aspects of a single...required legal notices, and coordinate legal action as needed. Review and reconcile tenant rent and Common Area Maintenance… more
- Hologic (Los Angeles, CA)
- District Service Manager - California Los Angeles, CA, United States San Diego, CA, United States Here at Hologic, we are driven by our passion to become the global ... problem solving and innovation. We're seeking a highly skilled and experienced Service Manager to lead the California Field Service Team. This role is responsible… more