- 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 Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… 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
- Kepro (Los Angeles, CA)
- …Reviewer to join our growing team in California. Job Summary As a Utilization Clinical Reviewer, you will leverage your expertise to meticulously assess medical ... will evaluate the medical necessity of psychiatric inpatient care to ensure appropriate utilization of services. This role is pivotal in maintaining the accuracy and… 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
- 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