• RN Inpatient Review Case

    Molina Healthcare (San Francisco, CA)
    …of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and ... expected length of stay for requested treatments and/or procedures. + Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its… more
    Molina Healthcare (03/04/25)
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  • Case Manager II, Acute Psychiatric

    Sutter Health (Berkeley, CA)
    …include psychosocial assessments and discharge planning for patients on inpatient psychiatric units. This position coordinates the utilization management, resource ... AND KNOWLEDGE:** A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization … more
    Sutter Health (03/04/25)
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  • Manager , Care Coordination (LCSW)

    Stanford Health Care (Palo Alto, CA)
    …Skills and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge ... to be discovered. Day - 08 Hour (United States of America) Department: Inpatient oncology, ICU coverage area TBD Commitment: Full-Time Schedule: 08-HR, Day Shift Why… more
    Stanford Health Care (03/18/25)
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  • Manager II Behavioral Health Services

    Elevance Health (Palo Alto, CA)
    ** Manager II Behavioral Health Services** **Location:** This position will work a hybrid model (remote and office). Ideal candidates must live within 50 miles of our ... insightful analytics to improve the delivery of care. The ** Manager II Behavioral Health Services** will be responsible for...Behavioral Health Utilization Management (BH UM), or Behavioral Health Case Management (BH CM) or a combination of both… more
    Elevance Health (03/20/25)
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  • Director, Post-Acute Care

    Sutter Health (Emeryville, CA)
    …or Master of Social Work (MSW) required. **CERTIFICATION & LICENSURE:** ACM-Accredited Case Manager is preferred. **TYPICAL EXPERIENCE:** 6 years recent relevant ... hospice, rehabilitation, and long-term care facilities. Works closely with the hospital's case management team, physicians, and post-acute care providers to ensure a… more
    Sutter Health (02/06/25)
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  • Mgr, Healthcare Services : ECM, Community Supports

    Molina Healthcare (San Francisco, CA)
    …following activities: care review /utilization management (prior authorizations, inpatient /outpatient medical necessity, etc.), case management, transition of ... experience **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management… more
    Molina Healthcare (03/21/25)
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