Utilization Manager Jobs in Orange
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Search Results - Utilization Manager Jobs in Orange
Equiliem-Orange
for assessing the medical appropriateness, quality, and cost-effectiveness of proposed hospital/medical/surgical services in accordance with established criteria.
Position Information
Department: Utilization Management
Work Arrangement: Full Office
Duties...
resume-library.com -
Chino, 13 mi from Orange
Knowledge in discharge planning/utilization management/case management terminology and functions, in both managed care and non-managed care environments.
2. Active state LVN license required upon hire and maintain current.
3. Current BCLS (AHA) or (ARC)...
icims.com -
Equiliem-Orange
information prior to submission to the Medical Director, follows up with the requester by communicating the Medical Director’s decision and documents follow-ups in the utilization management system.
Completes required documentation for data entry...
resume-library.com -
PIH Health Hospital-Los Angeles, 27 mi from Orange
and benefits.
As System Medical Executive for Surgical Procedural Services, this role focuses on driving revenue-generating growth, quality improvement, and utilization management within surgical services across all three PIH Health hospitals.
The medical...
appcast.io -
Impresiv Health-Orange
goals/priorities for the department.
Analyzes requests with the objective of monitoring utilization of services, this includes medical appropriateness and identifying potential high cost, complex cases for outpatient case management intervention...
resume-library.com -
Clementine-Yorba Linda, 6 mi from Orange
companies for pre-certification and utilization management
• Participating in discharge and aftercare planning
• Therapeutic meal support, while modeling a healthy relationship with food
• Provides safe, empathetic, and affirming care for each client...
Impresiv Health-Orange
coordination, authorization and utilization management of the assigned population of focus (Community Based Adult Services (CBAS), CalAIM, complex discharge and long term care (LTC) members residing in nursing facilities under custodial care) including members...
resume-library.com -
Blue Shield of California-Long Beach, 26 mi from Orange
of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management (UM)...
Pyramid Consulting, Inc-Orange
and telephonically to coordinate member care.
Conduct discharge planning. Educate providers on utilization and medical management processes.
Provide clinical knowledge and act as a clinical resource to non-clinical team staff.
Enter and maintain pertinent...
resume-library.com -
Equiliem-Orange
Minimum Qualifications:
High School diploma required.
5 years of health care/managed care experience required. Preferably in the following related areas of responsibility: Grievances and Appeals, Utilization Management and/or Quality Management...
resume-library.com -
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