Utilization Review Jobs in Los Angeles
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Search Results - Utilization Review Jobs in Los Angeles
Center For Discovery-Los Angeles
Aside from managerial responsibilities, the Program Director carries a small caseload to provide individual, family and group therapy. The Program Director provides oversight of clinical documentation and Utilization Review matters.
He/she ensures...
resume-library.com -
Centene-Los Angeles
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
• Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex...
L.A. Care Health Plan-Los Angeles
and tools while also performing utilization review of cases.
The Medical Director reports to the Senior Medical Director, Community Health. This position works closely with our Community Platform team as well as with other cross-functional teams within L.A...
appcast.io -
Pyramid Consulting, Inc-Los Angeles
with an interdisciplinary approach.
Utilization Review: Knowledge of resource management and alternative care recommendations for optimal patient outcomes.
Regulatory Compliance: Familiarity with healthcare regulations (TJC, Medicare, Medi-Cal) and documentation standards...
resume-library.com -
Infosys Limited-Los Angeles
Design and implement workflows for effective utilization review and care coordination.
• Leadership and Communication:
• Lead, mentor, and coach project teams to drive successful implementations.
• Collaborate effectively with internal teams including...
thecareerwallet.us -
Macpower Digital Assets Edge Private Limited (MDA Edge)-Los Angeles
for multidisciplinary review; defining the standards for integrating multiple utilization data reporting systems to develop and maintain a variety of statistical reports in a format which enables care providers to see variations in practice patterns that are adaptable...
resume-library.com -
Los Angeles
and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical Leave Act (FMLA), Group health and workers’ compensation claims.
• Meets (when...
icims.com -
Los Angeles
procedures, and performance standards and URAAC guidelines and state regulations.
Responsibilities:
MAJOR DUTIES AND RESPONSIBILITIES:
• Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity...
icims.com -
Los Angeles
or Medical Assistant (MA) certificate
• CPR Certification
PRIOR EXPERIENCE:
• Minimum 2 years of nursing experience, preferably in an ambulatory care setting
• Minimum 1 years of management and supervisory experience
• Background in utilization review, risk...
icims.com -
Los Angeles
Reporting system.
• Document and report patient safety concerns using the Patient Safety Reporting system.
• Facilitate medical staff drug utilization reviews (DURs) as deemed necessary.
• Exhibit basic competency in Microsoft Word, Microsoft Excel...
icims.com -
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