- Molina Healthcare (Long Beach, CA)
- …Utilization Management / Utilization Review is very essential to this role. Experience with Case Management is a plus._** **_This is a remote role (work from home). ... Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more
- Molina Healthcare (Long Beach, CA)
- …Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or ... hospitals as requested, may be required. This can vary based on the individual State Plan. **JOB QUALIFICATIONS** **Required Education** Graduate from an Accredited School of Nursing. **Required Experience** 3+ years hospital acute care/medical experience.… more
- Molina Healthcare (Long Beach, CA)
- …Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or ... hospitals as requested, may be required. This can vary based on the individual State Plan. **JOB QUALIFICATIONS** **Required Education** Graduate from an Accredited School of Nursing. **Required Experience** 3+ years hospital acute care/medical experience.… more
- Elevance Health (Woodland Hills, CA)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to… more
- Elevance Health (Cerritos, CA)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... appropriate. + Performs psychiatric assessments coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize… more
- Molina Healthcare (Long Beach, CA)
- …Productivity is important with turnaround times._** **_You will be performing audits for: case management, pediatrics and adults, UM audits, transition of care, ... auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case Management (CM), Member Assessment Team (MAT), Health Management… more