- UCLA Health (Los Angeles, CA)
- …leader with: + Current CA LVN licensure required + Two or more years of utilization review / utilization management experience in an HMO, MSO, IPA, ... in the issuance of adverse organization determinations. You will review for appropriate care and setting while working closely...for appropriate care and setting while working closely with denial coordinators and other staff to ensure the accurate… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II (After Hours Evening) Job Category: Clinical Department: Utilization Management Location: Los Angeles, ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management , and concurrent review ... can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management to a team of UM… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management , Assistant Manager, you will play a key role in processing and ... leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise...+ Work directly with a nurse team lead + Review pending claims for approval or denial … more
- Molina Healthcare (Long Beach, CA)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. +...analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory,… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Authorization Technician Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... achieve that purpose. Job Summary The Supervisor, Authorization Technician supports the Utilization Management (UM) Specialist by handling all administrative and… more
- Banc of California (Brea, CA)
- …relationship-based business banks focused on providing banking and treasury management services to small, middle-market, and venture-backed businesses. Banc of ... WE WIN(R) **THE OPPORTUNITY** Responsible for providing the planning, coordination, utilization and administration of MS-SQL relational databases and other file… more
- Banc of California (Manhattan Beach, CA)
- …procedures and state and federal regulations. + Effectively executes on contact management strategy through utilization of available tools and resources ... in person meetings. Regularly meets with internal business partners to communicate and review business results and pipeline management . + Treat people with… more
- UCLA Health (Los Angeles, CA)
- …and the development and implementation of action plans for research related denial management and prevention. The incumbent will optimize research authorizations ... + Knowledge in the functional operations of third party payors and utilization review agencies to expeditiously coordinate follow-up. + Interpersonal skills… more
- The County of Los Angeles (Los Angeles, CA)
- …methods include group, family, individual and conjoint therapy, clinical case management , and crisis intervention. Positions allocable to this class also provide ... problem, which may include individual, group, family or marital counseling, case management , and/or referral to another treatment source such as a psychiatrist, a… more