- Prime Healthcare (Inglewood, CA)
- …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization … more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... and determinations within required turnaround times specific to the case type. Identifies requests needing medical director ...setting. Previous experience to have a strong understanding of Utilization Management / Case Management … more
- UCLA Health (Los Angeles, CA)
- …delivery for MSO members. + Ensure seamless integration of various clinical functions with Utilization Management , such as Case Management , Quality ... Description We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation,...programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group… more
- The County of Los Angeles (Los Angeles, CA)
- …the following: + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT ... appropriateness of the level of care. For this examination, Case Management is a collaborative process that...vacancy in Department of Health Services, Harbor-UCLA Medical Center, Utilization Management Division. May also be used… more
- University of Southern California (Los Angeles, CA)
- …populations. The RN case manager role integrates the functions of utilization management , quality management , discharge planning assessment, and ... Participates in InterQual competency testing as requested by department director . + Outcomes Management * Participates in...Qualifications: + Pref Bachelor's degree + Pref 1 year Case management or utilization review… more
- Elevance Health (Los Angeles, CA)
- **Clinical Operations Medical Director ** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical management staff… more
- University of Southern California (Alhambra, CA)
- … of specific patient populations. The role integrates the functions of complex case management , utilization management , quality management ... as requested by department director or Medical Director . + Outcomes Management 1. Participates in...5 years Clinical experience + Req 2 years Ambulatory case management or utilization review… more
- Molina Healthcare (Los Angeles, CA)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- University of Southern California (Arcadia, CA)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... follows up to resolve problems with payers as needed. + Completes utilization management for assigned patients. + Coordinates/facilitates patient cares… more
- Elevance Health (Los Angeles, CA)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... **Behavioral Health Medical** ** Director -Psychiatrist** **Appeals** **Location:** This role enables associates to...aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- UCLA Health (Los Angeles, CA)
- …working within a health plan, required + Knowledge of Medicare Advantage experience with utilization management , quality improvement, or case management , ... + Contribute to interdisciplinary care team rounds for complex case management . + Serve as clinical SME...required + Minimum of 2 years of experience in Utilization Management , required + 2 or more… more
- Elevance Health (Los Angeles, CA)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management ** **Post Acute Care Benefit Utilization Management ** ... of care for the people we serve._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the medical management staff ensuring… more
- Howmet Aerospace (Torrance, CA)
- Howmet Fastening Systems (HFS) is seeking an IT Director to develop and deliver an IT strategy to modernize the technology of the HFS business unit. This role will ... Total Number of IT Department Employees: ~80 + The Director of Information Technology develops and drives global Information...solutions throughout each business unit. + Ensure the efficient utilization of IT resources - personnel and equipment -… more
- Elevance Health (Los Angeles, CA)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician and oversees the...you will make an impact:** + Supports the Medical Management staff to ensure timely and consistent responses to… more
- University of Southern California (Los Angeles, CA)
- …budget preparation, expense monitoring, productivity monitoring, payor mix, FTE tracking/ utilization , revenue tracking, and billing integrity. Works with Clinical ... related to data analysis, process improvement, and strategic/operational project management , and will work closely with managers, directors, clinicians, quality… more
- Sevita (Signal Hill, CA)
- …all every day. Join us today, and experience a career well lived. **Operations Management Area Director ** Everybody needs a job but only extraordinary people ... documentation. + Implement area core growth strategy to increase census, maximize utilization and occupancy percentages, and assist with new start development. +… more
- University of Southern California (Los Angeles, CA)
- …services through appropriate levels of qualified, competent staff. + Assists the Director in staff performance appraisals and performance management activities ... includes creating staff schedules, daily assignments, vacation approvals, timecard management , contributing toward department goals, and participating in necessary… more
- Cedars-Sinai (Beverly Hills, CA)
- …to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the ... The Case Manager is responsible for the case management of patient while hospitalized and...date of discharge. + Communicates regularly with CSMPN Medical Director , Employee Health Services, Risk Management , and… more
- Cedars-Sinai (Beverly Hills, CA)
- …Research Operations is accountable to the Department Chair and/or Institute Executive Director and serves as the primary source of information for the department. ... Investigators (PIs), staff and students to provide analytical support and project management in fulfilling the established goals and objectives for the department… more
- University of Southern California (Los Angeles, CA)
- …Experience in OR/acute hospital as an RN and understands departmental capital expenditure, case management and operational budget process experience. + Req OR ... for the quality of patient care, efficiency of operations, and human resources management for area(s) assigned. S/he will strive to achieve the optimal patient… more