- Dignity Health (Stockton, CA)
- …atmosphere that fosters communication trust and personal growth. **Responsibilities** **Position Summary:** Case Manager 1 assists Case Managers in ... to patients and their families acting as liaison between the case manager treatment team and physicians referral sources outside therapists community agencies… more
- Baylor Scott & White Health (Sacramento, CA)
- …Note: Benefits may vary based on position type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff. You oversee ... members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management, utilization review and different care levels. + Outstanding… more
- ICW Group (Sacramento, CA)
- …evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and coordinate appropriate medical treatment and ... + Measures and reports on interventions to determine the outcome of the case manager 's involvement to include clinical, financial, variance, quality of life,… more
- Insight Global (Sacramento, CA)
- …reimbursement! 67 cents per gallon. 10-60 miles radius. A Brief Overview Hospice Nurse Case Manager Day-To-Day: you will visit 4-6 patients a day depending on ... location. As a Hospice Nurse Case Manager , you will play a critical...and other relevant agencies. Coordinating optimal care and resource utilization for patients and families. Accurate Documentation: Documenting patient… more
- Sunrun (Sacramento, CA)
- …in through our commitment to diversity, inclusion and belonging. **Overview** The O&M Case Manager is responsible for coordinating effective execution of field ... and develop partner or branch relationships including weekly/monthly reviews, utilization and workload management, process updates and identification and resolution… more
- United Therapeutics (Sacramento, CA)
- …to meet the needs of the intended audience and contributors + End-to-end case processing, including data entry, QC, medical review , and regulatory submissions ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- Highmark Health (Sacramento, CA)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to assure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case management, and… more
- Highmark Health (Sacramento, CA)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case management, and… more
- Sutter Health (Roseville, CA)
- …acute care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... A broad knowledge base of health care delivery and case management within a managed care environment. + Comprehensive...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- Ross Stores, Inc. (Sacramento, CA)
- …and development for our teams\. **GENERAL PURPOSE:** The Area Loss Prevention Manager \(ALPM\) is responsible for protecting the assets of Ross Stores, Inc\. ... Operations, MPT, etc\.\) and analytics\. * Identify shortage risks through regular review of indicator reports; partner with stores to develop action plans to… more
- Hospice Of San Joaquin (Stockton, CA)
- …of the patient and family. + Follows treatment plan established by the Registered Nurse/ Case Manager . + Follows scope of practice when providing nursing care. + ... Makes recommendations to the Case Manager for action/follow-up of patients. +...the Hospice philosophy and Hospice's services. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW : Ensures compliance with the program… more
- Deloitte (Sacramento, CA)
- …the C-Suite. Our services extend beyond HR to include the CEO, CFO, Risk Manager , and Business Unit leaders, delivering value and creating impact for our clients. ... client expectations and working with leading global businesses? Your RoleAs a Manager in Employer Health, you will provide strategic and technical employee benefit… more
- Nelnet (Sacramento, CA)
- …in territory by reviewing client contracts, maintaining contract end dates, championing utilization , and proactively engaging clients to extend/ review the term ... for people where they live, learn and work. The Manager - Account Executives - Sales - NCC -...one time per year to deliver an annual account review communicating Nelnet's value and long-range planning objectives. 9.… more
- Elevance Health (Walnut Creek, CA)
- …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... and/or medical policies. May collaborate with healthcare providers. Focuses on relatively complex case types that do not require the training or skill of a… more
- Dignity Health (Rancho Cordova, CA)
- …efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality ... and best practice in medical necessity determination and concurrent review . This position will supervise the department in an...Minimum of 3 years in a Care Coordination or Case Manager role. - Clear and current… more
- Elevance Health (Walnut Creek, CA)
- …policies when making medical necessity decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director review or ... Associate Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit** **Management/ Utilization ** ** Review ** **Schedule:** **Monday-Friday 9AM-5:30PM Central Time**… more
- Elevance Health (Walnut Creek, CA)
- …the medical necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts ... + Extensive orthopedic surgery experience preferred. + Experience with utilization management, especially with CMS guidelines preferred. For candidates working… more
- US Foods (Livermore, CA)
- …through the following: consultative services to aid customers through improved utilization of the category; sales force training; conducting product demonstrations ... and menu ideas prioritized for top penetration opportunities to achieve Division case growth objectives for category, as well as, realize Exclusive Brand (EB)… more
- CTTX Health (Rancho Cordova, CA)
- …deadlines. + Attend and/or participate in facility meetings as directed by Center Manager (may include utilization review , infection control, disaster ... assistant or physical therapist education program accredited by CAPTE or in the case of a graduate of an international physical therapist assistant program or… more
- County of El Dorado (Placerville, CA)
- …have experience in providing SUD services and performing Quality Management and/or Utilization Review activities. They would have excellent written and verbal ... + Questions Description The County of El Dorado is recruiting applicants for the Manager of Mental Health Programs, located in Placerville, CA. CLICK HERE TO VIEW… more