Utilization Review Jobs in Los Angeles
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Search Results - Utilization Review Jobs in Los Angeles
Macpower Digital Assets Edge Private Limited (MDA Edge)-Los Angeles
Health Plan guidelines and patient needs.
Assures compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements.
Provides direction to staff regarding utilization review, care coordination, discharge...
resume-library.com -
GQR Healthcare-Los Angeles
per week
• Shift: 8 hours, days
• Employment Type: Travel
MANAGER OF CASE MANAGEMENT
Must have experience Managing inpatient case manager processes but only have 21 direct reports, LVNs and non-licensed staff, discharge planners.
Utilization review...
Macpower Digital Assets Edge Private Limited (MDA Edge)-Los Angeles
JOB OVERVIEW: As the Director of Case Management, you will be the cornerstone of our efforts to deliver high-quality, cost-effective healthcare services. You'll lead initiatives in utilization review, discharge planning, and care coordination across...
resume-library.com -
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
of Utilization review/management, discharge planning or case management. Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.).
Demonstrated ability to utilize written and verbal communication, interpersonal...
resume-library.com -
Kaiser Permanente-Los Angeles
Job Summary:
Develops, manages and directs the Utilization Management programs in a Service Area or a Medical Center. Develops and manages programs that emphasize appropriate admissions as well as concurrent and retrospective review of care.
May...
appcast.io -
Ampcus Incorporated-Los Angeles
and interpreting medical information from patient records.
Working knowledge of laws, rules, and regulations regarding utilization review and discharge planning functions of government programs such Medicare, Medi-Cal, and CCS.
Clinical experience sufficient...
resume-library.com -
Health Net-Los Angeles
development, monthly 1:1s, mentorship/career development, and annual evaluations
• Support Chief Medical Officer in the execution of strategic clinical initiatives
• Participate in utilization review studies, evaluate adverse trends; and collaborate with CMO...
Jamie Grayem-Los Angeles
standards and requirements.
• Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services across the continuum of care.
• Assists in conducting statistical studies in utilization trends, patterns...
jobvertise.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 -
Encompass Health-Los Angeles
of hospital plans, including the Provision of Care/Scope of Services, Leadership, Information Management, Utilization Review, Infection Control, and Patient Safety plans. Oversee risk management activities, including completion of incident reports, notice...
Jamie Grayem-Los Angeles
and other work 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...
jobvertise.com -
Los Angeles
Overview:
The Floater Pharmacist appropriately dispenses prescribed drugs, handles incoming physician calls, logs data into the computer, performs Rx workflow processing, and conducts drug utilization reviews.
This position will fill in (as needed...
avitapharmacy.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
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 -
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