- Sutter Health (Berkeley, CA)
- …and others to ensure appropriate utilization and quality care through utilization review , tracking and evaluation and objectively compare criteria with ... clinical nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical, nursing… more
- Highmark Health (Sacramento, CA)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to assure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- LA Care Health Plan (Los Angeles, CA)
- …by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health ... Care Management Specialist II Job Category: Clinical Department: Care Management...the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and… more
- US Marine Corps (Twentynine Palms, CA)
- …organization functioning smoothly and effectively. Responsibilities Serves as the Clinical Specialist within the Behavioral Health program, Community Counseling ... policies, conducts screenings, clinical counseling services and case management services for Behavioral Health Branch programs. Serves as the first point of contact… more
- Cedars-Sinai (Los Angeles, CA)
- …Medical Directors of the CSMN, CSMN primary care physician leadership, CSMN specialist physician leadership, and executive leadership within the CSMN, including but ... conditions and MH disorders. + Provides regularly scheduled caseload reviews to behavioral health specialists. Caseload reviews focus primarily on patients who are… more
- HCA Healthcare (Riverside, CA)
- …standards for ACGME simulation requirements. This positions also manages the utilization of simulation resources to ensure fidelity of curricula and assessments ... plan and implement special projects. + Manage the simulation evaluation and review process. + Ensure department alignment with organizational strategic goals and key… more