- Molina Healthcare (San Jose, 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
- 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 (Pleasanton, CA)
- …or similar* Health Care Quality (HACP, CPHQ, HCQM) certification or similar* Case Management, utilization review and/or safety Certification (CCM, HCQM, CMGT-BC, ... key organizational and industry partners, including quality, compliance, coding, case management, clinical providers, other multidisciplinary teams. + Coordinates… more
- Elevance Health (Walnut Creek, 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
- Horizon Services, Inc. (Pleasanton, CA)
- …months, and $500 after 12 months of employment) JOB TITLE: Clinical Program Manager LOCATION: Pleasanton, CA Employment Type: Full-time Who are we? Horizon Services, ... make a difference in people's lives? We are seeking a Clinical Program Manager who is passionate about serving diverse communities. Bilingual candidates fluent in… more
- Molina Healthcare (San Jose, 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