- Prime Healthcare (Chino, CA)
- … Case Management Department under the direction of the assigned Case Manager /Social Worker in the development and implementation of the discharge plan. ... EDUCATION, EXPERIENCE, TRAINING Required qualifications. 1. Knowledge in discharge planning/ utilization management / case management terminology… more
- Dignity Health (Northridge, CA)
- …understanding of Utilization Review to progress plan of care. + Understand how utilization management and case management programs integrate. + ... care centers. Visit dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager (Care Coordinator) Case … more
- HCA Healthcare (Riverside, CA)
- …you will need:** + Registered Nurse (RN) with current California license required, Case Management Certification or utilization review preferred + ... passionate about delivering patient-centered care?** Submit your application for Case Management Coordinator position and spend more...what makes us great and apply today! The RN Case Manager facilitates the progression and transition… more
- Elevance Health (Costa Mesa, CA)
- …states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of ... **Telephonic Nurse Case Manager II** **Location: This is...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Providence (Orange, CA)
- …Rehab, Pediatrics, Transplant, or Wound Care upon hire. + 3 years Experience in utilization management or case management . **Why Join Providence?** ... **Description** **Care Manager RN at St Joseph Hospital-Orange in Orange,...+ Master's Degree in Related field. + Certification in Case Management (CCM, ACM) upon hire. +… more
- Molina Healthcare (Riverside, CA)
- …to a 3 day/12 hour shift from then on._** **_Previous experience with Emergency Room Utilization Management / Utilization Review is preferred for this role. ... Experience with Case Management is a plus._** **JOB DESCRIPTION**...or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current… more
- Prime Healthcare (Ontario, CA)
- … Case Management Department under the direction of the assigned Case Manager /Social Worker in the development and implementation of the discharge plan. ... discharge plan. #LI-AS1 Qualifications Required qualifications: + Knowledge in discharge planning/ utilization management / case management terminology and… more
- Elevance Health (Cerritos, CA)
- … II Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health Case Management (BH CM) ... an inbound and outbound calls related to accessing BH Services. Oversights the clinical Case Management team in managing case consultation and care… more
- Deloitte (Costa Mesa, CA)
- …phrases like "global effective tax rate reduction" and "efficient global cash utilization " peak your interest? Do you enjoy providing international compliance and ... on date: 03.31.2025 What you'll do As a Tax Manager , you will work within an engagement team and...Professional Scrum Product Owner (PSCPO) - SCRUM.org and Project Management Professional (PMP + CBAP - Certified Business Analysis… more
- Elevance Health (Costa Mesa, CA)
- …and experiences:** + AS or BS in nursing preferred. + Certification as a Case Manager is preferred. + Participation in the American Association of Managed ... management plan and modifies as necessary. + Assists with development of utilization /care management policies and procedures. + Participates in or leads… more
- Deloitte (Costa Mesa, CA)
- …on project delivery covering aspects such as quality, timelines, risk, and issue management . + Track internal metrics such as utilization , Budget Vs Spend, ... and Economic Trade Sanctions domain. As a Data Analytics Manager focusing on AML, you will have the opportunity...communicate effectively to all levels of client and engagement management . + Capable of balancing multiple projects with strong… more
- Sysco (Riverside, CA)
- **JOB SUMMARY** The District Sales Manager (DSM) role requires exceptional management of sale performance among Sales Consultants (SCs). This position is ... talent of their sales consultants to achieve profitable planned case and GP growth **RESPONSIBILITIES** + Manages the performance...the SC + Fully leverages our CRM in the management of SC's sales planning, prospecting, and daily customer… more
- J&J Family of Companies (Irvine, CA)
- …supporting terms and conditions redlines for commercial contracts. This Lead Analyst, Contract Management will work closely with the Sr. Manager , Contract ... and workflows. Responsibilities will include, at the direction of the Senior Manager , Contract Management , coordination of terms and conditions changes,… more
- Dignity Health (Long Beach, CA)
- …effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs ... emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post… more
- Elevance Health (Costa Mesa, CA)
- …diploma or equivalent and a minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or ... commute each way of a relevant Elevance Health location. The **Nurse Medical Management ll** is responsible to collaborate with healthcare providers and members to… more
- US Tech Solutions (Orange, CA)
- …Service department regarding health network enrollments. Assists the inpatient Medical Case Manager in gathering medical records, obtaining appropriate coding ... Service department regarding health network enrollments. Assists the inpatient Medical Case Manager in gathering medical records, obtaining appropriate coding… more
- Elevance Health (Cerritos, CA)
- …policies, and CMS Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests involving radiology imaging requests, ... maintain knowledge of applicable clinical criteria and relevant Carelon Medical Benefits Management policies pertaining to utilization review. + Demonstrate and… more
- Elevance Health (Cerritos, CA)
- …reviews of high-tech diagnostic imaging, cardiac testing and sleep management services. Medical Directors in Clinical Operations determine the medical ... necessity of outpatient radiology, cardiology, sleep management , endoscopies and surgical site of care requests using...**How you will make an impact:** + Perform physician-level case review, following initial nurse review, of high-tech diagnostic… more
- Danaher Corporation (Brea, CA)
- …experience that includes some of the following: infection detection/control, decision support, utilization management , case management , quality outcome ... Clinical Sales and Implementation team and report to the Clinical Sales Manager responsible for advancing Beckman Coulter's market leader position as the diagnostics… more
- Illumination Foundation (Santa Ana, CA)
- …The Program Coordinator is an administrator role dedicated to upkeep, management , and oversight of front-end and back-end programmatic processes. These include ... skills. This individual will also be centrally involved in communicating information to management and lead housing entities, and will be relied on for insight into… more