- Alameda Health System (Oakland, CA)
- …3 years, experience in Case Management in an acute setting or utilization review at a medical group or health plan. Required Licenses/Certifications: Active ... Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management . **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The… more
- Henkel (Bay Point, CA)
- …support the Global Quality Key + Account Manager. Drive the proper utilization of the global customer requirements and customer satisfaction database. **What makes ... a good fit** + engineering + incident investigation + root-cause-analysis + quality management systems + quality international standard + HACCP + quality core tools… more
- Alameda Health System (Oakland, CA)
- …Health Information Management or its proxy Provide on-line base hospital medical control and consultation for Alameda County EMS providers. Be responsible, on a ... and scholarly work for Alameda Health System, under employment from Alameda Health Medical Group. Services will be on-site at Highland Hospital. **DUTIES & ESSENTIAL… more
- Alameda Health System (Oakland, CA)
- …+ Highland General Hospital + FQ MCH/OB Clinic (K6) + Full Time - Day + Management + $85.55 - $142.40/ Hour + Req #:42908-31868 + FTE:1 + Posted:October 15, 2025 ... of the designated service line including business development, personnel management , fiscal management , strategic planning, physician recruitment plan,… more
- Alameda Health System (Oakland, CA)
- …CA + Highland General Hospital + Emergency + Full Time - Night + Management + TBD + Req #:43134-32050 + FTE:1 + Posted:Yesterday **Summary** **SUMMARY:** Under ... the organizational structure of a unit which promotes effective and economic utilization of personnel and supplies; assures availability and operability of supplies… more
- Alameda Health System (Oakland, CA)
- …Highland General Hospital + FQ MCH/OB Clinic (K6) + Full Time - Day + Management + $64.00- $96.00 + Req #:42878-31844 + FTE:1 + Posted:September 24, 2025 **Summary** ... on each nursing unit for which responsible. Promotes effective and economic utilization of personnel and supplies. Monitors utilization of personnel and… more
- Alameda Health System (Oakland, CA)
- …to improve imaging quality, reviewing daily assignments with staff and management , performs complex diagnostic ultrasound procedures of the cardiovascular system for ... of Care Standards and physician orders to achieve the goal of effective utilization of services and improved patient outcomes. When applicable, work with Medical… more
- Elevance Health (Walnut Creek, CA)
- Utilization Management / Medical Management Nurse - CA (JR169412) **Virtual:** This role enables associates to work virtually full-time, with the ... 8am - 6pm PST. Rotating Weekends and holidays. The ** Medical Management Nurse** is responsible for review...Med/Surg, Critical Care, ER, Telemetry, etc. strongly preferred. + Utilization management /review within managed care or hospital… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- Elevance Health (Walnut Creek, CA)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...and/or eligibility information. + May act as liaison between Medical Management and internal departments. + Responds… 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 ... acute hospital admission, need for continued stay, and proper utilization of physician, nursing, and ancillary services. Responsible for...hospital administration, medical staff, patient registration and representatives of review organizations… more
- Elevance Health (Walnut Creek, CA)
- …or healthcare leadership preferred. + Experience advising medical cost management , utilization management , payment integrity, or provider performance ... & Analytics (RDA)** + **Cost of Care / Payment Integrity** + **Care Management / Utilization Management (CM/UM) Modernization** + **Provider Networking… more
- Alameda Health System (Oakland, CA)
- …of financial analyses including cost of care to reimbursement, denials management , and non-reimbursed services, promoting effective resource utilization , ... nursing and staff education including InterQual(R) criteria methodology, resource management , medical necessity guidelines, payer sources, clinical outcome… more
- Abbott (Alameda, CA)
- …and accountability across business domains to support ethical and effective data utilization . **Demand/Intake Management ** + Build deep relationships with our ... spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues… more
- CDM Smith (Walnut Creek, CA)
- …Unit:** COR **Job Description:** CDM Smith is seeking a Senior IT Asset Management Specialist to lead and manage all aspects of the software lifecycle, including ... services. * Keep us running efficiently: Maintain and update IT asset management databases, procurement tools, and compliance systems to ensure accurate, real-time… more
- BeOne Medicines (Emeryville, CA)
- **General Description:** The Associate Director, Digital Quality Management Systems (QMS) Operations and User Experience, is responsible for ensuring the efficient ... engagement initiatives, including webinars, workshops, and documentation to improve system utilization . + Establish a knowledge base and self-service tools to… more
- Sutter Health (Emeryville, CA)
- …will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to develop ... develop expertise on matters regarding physician practice patterns, over- and under- utilization of resources, medical necessity, documentation best practices,… more
- Sutter Health (Oakland, CA)
- …will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to develop ... develop expertise on matters regarding physician practice patterns, over- and under- utilization of resources, medical necessity, documentation best practices,… more
- Elevance Health (Walnut Creek, 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 to work virtually full-time, with the exception of… more
- Stantec (Walnut Creek, CA)
- …Environmental Services Water Sector provides water resource and flood management , water infrastructure, and water-related nature-based solutions in California's ... 25% of time. - Responsible for exceeding client expectations through strong account management across the BC and personally leading accounts for major clients in the… more
