- Prime Healthcare (Inglewood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189094/ director -of- case - management utilization - ... Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Director of Case Management … more
- LA Care Health Plan (Los Angeles, CA)
- …of varied 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
- Cedars-Sinai (Los Angeles, CA)
- …with internal and external stakeholders. + Promotes the role of Case management , medical social work & utilization management within the organization ... **Key Job Responsibilities** Provides overall strategic and operational leadership of the Case Management Department which encompasses the disciplines of Care… more
- Providence (Santa Monica, CA)
- **Description** **THE ROLE** The Director , Case Management promotes and supports the mission, vision and objectives of Saint John's Health Center and is ... responsible and accountable for the clinical, fiscal, and personnel management of Case Management on a 24 hour, 7 day basis. Develops and utilizes mechanisms… 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 managment. Recognizing the patient's...-by- case basis at each ministry by the Director of Care Management in consultation with… 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
- Cedars-Sinai (Los Angeles, CA)
- …and vetting of any community MH provider as needed. + Supports and advises Utilization Management , CS 360, and population health teams as needed, including ... other CSMN providers of Population Health services, the Medical Director of Pain Management , and Population Health...to track all assigned patients and prioritize patients for case review and treatment adjustment. + Recommends any treatment… more
- LA Care Health Plan (Los Angeles, CA)
- …that the programs align with our operational systems and tools while also performing utilization review of cases. The Medical Director reports to the Senior ... review of cases and participates in our care management programs periodically. Provide utilization review and...and State Fair Hearings and periodically attend the inter-disciplinary case conferences with our Care Management teams.… more
- Sevita (Alhambra, CA)
- …strategy to manage census, maintain occupancy, improve daily attendance, and/or maximize utilization + Financial Management + When applicable, approve purchase ... us today, and experience a career well lived. **Program Director for Family Home Agency (FHA) Host Home Program**...services_** Are you an experienced human services professional with management ability and the energy and focus to run… more
- Elevance Health (Los Angeles, CA)
- …preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For ... **Clinical Ops Associate Medical Director ** **Orthopedic Surgery** **Location:** This is a virtual...necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. +… more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary ... and receives clinical supervision as needed from the Medical Director of Care Management . The position is...care with internal LA Care departments such as Care Management (CM), Utilization Management (UM),… more
- Elevance Health (Los Angeles, CA)
- …**Preferred skills, qualifications and experiences:** + Prior experience in inpatient Utilization Management , preferred. + Knowledge and/or experience of MCO, ... in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and… more
- Providence (Tarzana, CA)
- …Healthcare related field (Acute, Ambulatory, Post-Acute, etc.) + 2 years of 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… more
- Cedars-Sinai (West Hollywood, CA)
- …guidance, including aiding in resolving any conflicting project decisions. Discusses business case scenarios, presents to senior management and guides team(s) on ... responsible for managing budget, costing, timing and other resources including vendor management , staffing and/or deliverables to ensure utilization within the… more
- Elevance Health (Los Angeles, CA)
- …critical thinking skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate ... treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not...about plan benefits and physicians and may assist with case management . + Collaborates with leadership in… 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
- UCLA Health (Los Angeles, CA)
- …Campus under the direct supervision of Sterile Processing MSO, Asset Manager, Assistant Director of the Operating Room and the Director of Perioperative ... Incumbent will collaborate along with the SPD Manager and the Director of Perioperative Services regarding operations within the sterile processing department.… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …labor/delivery, IBCLC/CLC, experience with quality improvement or program development, case management experience. Qualifications Basic Requirements: English ... and the Women Veterans Program Manager (WVPM) and Women's Health Medical Director . Facilitates coordination of maternity care for pregnant Veterans on inpatient… more
- Griffith Company (Los Angeles County, CA)
- …and sequence of operations. + Coordinate manpower and equipment utilization . + Assist project manager in conducting effective pre-construction/pre-planning meetings. ... perform the essential functions of the job. + Must utilize effective management techniques to maximize project performance. + Thorough understanding of corporate and… 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