- 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
- 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
- Providence (Torrance, CA)
- **Description** Under the supervision of Regional Director of Care Management , the Utilization Management Coordinator is responsible for providing ... months (180 days) of hire. + 3 years EPIC Case Management and ADT Patient Access. **Why...Multiple shifts available **Career Track:** Admin Support **Department:** 7000 UTILIZATION MGMT CA SOCAL **Address:** CA Torrance 4180 W… more
- Genesis Healthcare (Los Angeles, CA)
- …care management goals. 9. Works collaboratively with the Director or Sr. Director of Case Management to update strategic business plan and ensure ... In conjunction with the Director or Sr. Director , acts as case management ...of clinical nursing experience is required. Prior experience in utilization review, case management or… 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
- Elevance Health (Los Angeles, CA)
- **Clinical Operations Medical Director ** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical management staff… 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
- 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 + 2 or more… more
- Elevance Health (Los Angeles, CA)
- **Medical Director -PSCCR** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... unless an accommodation is granted as required by law. The **Medical Director -PSCCR** is responsible for the administration of physical and/or behavioral health… more
- Elevance Health (Los Angeles, CA)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician and oversees the...you will make an impact:** + Supports the Medical Management staff to ensure timely and consistent responses to… 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
- 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
- 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
- J&J Family of Companies (Los Angeles, CA)
- …Plans' and MCOs' Medical Directors, Case Managers, Pharmacy Directors, and utilization management staff; Home Infusion Companies, and JBI approved vendors. ... verification, pre-authorization, billing, coding, claims, and appeals / grievances; practice management , as well as Medicare and Medicaid rules and regulations. The… more
- Dignity Health (Long Beach, CA)
- …when appropriate, discharge planning activities, and coordination with the multidisciplinary team/ Utilization Review Case Manager for referral to a CCS-paneled ... **Job Summary and Responsibilities** Under the general guidance of the Director and Manager of Rehabilitation Services, the Occupational Therapist administers… more
- Dignity Health (Long Beach, CA)
- …when appropriate, discharge planning activities, and coordination with the multidisciplinary team/ Utilization Review Case Manager for referral to a CCS-paneled ... **Job Summary and Responsibilities** Under the general guidance of the Director of Rehabilitation Services and Therapy Manager; the Physical Therapist administers… more