Utilization Manager Jobs in Rancho Cordova
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Search Results - Utilization Manager Jobs in Rancho Cordova
Blue Shield of California-Rancho Cordova
Your Role
Reporting to the Sr. Director, Utilization Management, the role of the Director, Commercial Utilization Management is critical to the success of Blue Shield of California and the Utilization Management department in realizing its goals...
Rancho Cordova
Health Services Research (HSR), Utilization Management, Quality Management and various other departments, in the production of indicators and reports which incorporate measures of resource consumption (costs), clinical efficacy, and health and service...
icims.com -
Blue Shield of California-Rancho Cordova
Your Role
The Utilization Management Prior Authorization team accurate and timely prior authorization of designated healthcare services, continuity or care, and access to care clinical review determinations. The Utilization Management Nurse, Senior...
Rancho Cordova
our website at www.dignityhealth.org. You can also follow us on Twitter and Facebook.
Responsibilities:
The Utilization Management (UM) Manager is responsible for managing day-to-day UM operations within the markets, focusing on effective team...
icims.com -
Blue Shield of California-Rancho Cordova
Your Role
The Utilization Management team reviews the inpatient stays for our members under the guidelines for nationally recognized levels of care. The Utilization Management Nurse, Senior will report to the Utilization Management Nurse Manager...
Rancho Cordova
up to or including supervisory role
• Experience in Utilization Management Case Management or Care Coordination Managed Care is preferred
Required Minimum Knowledge, Skills and Abilities:
• Knowledge of current nursing technique, principles...
icims.com -
Blue Shield of California-Rancho Cordova
Your Role
The Utilization Management Prior Authorization team ensures accurate and timely prior authorization of designated healthcare services, continuity or care, and access to care clinical review determinations. The Manager, Utilization...
Blue Shield of California-Rancho Cordova
metrics.
• Process Faxed /Web Portal /Phoned in Prior Authorization or Hospital Admission Notification Requests, Utilization Management (UM)/Case Management (CM) requests and/or calls left on voicemail.
• Select support for Case Manager such as mailings...
Blue Shield of California-Rancho Cordova
metrics.
• Process Faxed /Web Portal /Phoned in Authorization or Hospital Admission Notification Requests, Utilization Management (UM)/Case Management (CM) requests and/or calls left on voicemail.
• Select support for Case Manager such as mailings...
Blue Shield of California-Rancho Cordova
years managed care experience preferred.
• Comprehensive knowledge of case management, discharge planning, utilization management, disease management and community resources preferred
• Behavioral health, oncology, or OB/NICU/pediatrics experience...
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