- Community Health Plan of Washington (Eugene, OR)
- …appropriate alternatives. * Identifies and determines medical necessity of out of network ( OON ) requests for services. * Assures referrals are complete ... Communicate effectively with medical director regarding identified variances within the case against criteria utilized for medical review. * Regularly communicates… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** The Out of Network ( OON ) Clinical Case Manager (CM) provides timely and appropriate coordination of ... Driver's License - CA Department of Motor Vehicles; Accredited Case Manager (ACM) - American Case...repatriate patients into the Sharp Healthcare system and/or contracted network . The OON CM assesses, develops, implements,… more
- Sharp HealthCare (San Diego, CA)
- …Nursing & Psychiatric Technicians -REQUIRED **Preferred Qualifications** + Experience as a case manager or discharge planner interacting with managed care ... appropriate. Assists with transfers to SNF of Medical Group members from Out of Network ( OON ) and /or Out of Area (OOA). + Census and roundsReviews and updates… more
