Utilization Review Jobs in San Diego
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Search Results - Utilization Review Jobs in San Diego
Aurora San Diego-San Diego
to third party payers
Recordkeeping: Maintains appropriate records of the Utilization Review Department
Training: Provide staff in-service training and education
Maintains confidentiality of patients at all times
Ability to cope well with stress...
resume-library.com -
Cynet Health-San Diego
source of payment for in-patient stay.- Provide information in response to queries from doctors' offices, families, and outside facilities.- Deliver case management, social services, utilization review, and discharge planning daily and on scheduled...
Macpower Digital Assets Edge Private Limited-San Diego
utilization of resources which meet 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...
resume-library.com -
Aurora San Diego-San Diego
appeals to third party payers
• Recordkeeping: Maintains appropriate records of the Utilization Review Department
• Training: Provide staff in-service training and education
• Maintains confidentiality of patients at all times
• Ability to cope well...
workable.com -
Family Health Centers of San Diego-San Diego
communications.
Fully versed in the functions, services and positions of FHCSD departments and programs that require nursing support.
Maximizes revenue and possesses excellent working knowledge of payor systems, billing and utilization review.
Other duties...
Cynet Health-San Diego
Certifications:** Not specified**Must-Have:** Not specified**Job Description:**- Perform comprehensive utilization reviews.- Coordinate patient care with interdisciplinary teams.- Evaluate and ensure appropriate use of resources.- Deliver effective case...
Aurora San Diego-San Diego
and Utilization Review companies.
Obtain pre-authorization for admission when needed. Completes face sheet; assigns patient identification number.
Conducts actual admissions during regular hours; checks documentation on after hour admissions.
Answer numerous...
resume-library.com -
CenterWell Home Health-San Diego
and standards.
• Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed...
AMN Healthcare Nursing-San Diego
2964.09 - $3266.55
The Brand new state of the art San Diego Medical Facility is looking for a Case Manager to assist with excellent patient care in the Emergency Department.
Required Qualifications
Case Management / Utilization Review, prefer Kaiser case...
Imperial Beach Community Clinic-San Diego
Review and analyze reports from managed care health plans to identify utilization and case management areas for improvement.
Ensure compliance with health plan utilization and Quality Management requirements.
Assist clinics in working with hospital...
Amerit Consulting-San Diego
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 to understand...
mindmatch.ai -
San Diego
such as utilization review or managed care also useful.
• One to two plus years of recent clinical experience and/or one to two years of recent managed care experience.
• Achieves recognized certification in case management within company-designated timeframes
• Ability...
icims.com -
talent4health-San Diego
into the utilization management or care management system at the time of the telephone call or fax to include any authorization updates. Reviews and evaluates proposed services utilizing medical criteria, established policies and procedures, Title 22, Medicare...
HealthRIGHT 360-San Diego
budgets.
• Participate in regular meetings with executive leadership to review budgets, utilization, and quality targets and progress toward goals.
• Develops and implements policies pertaining to the Medical Department.
• Provides medical supervision...
appcast.io -
Sharp HealthCare-San Diego
of insurance, utilization review, scheduling requirements and support of front desk responsibilities. Able to operate and maintain department equipment.
• Clinical Expertise:
Exhibits superior critical thinking skills. Physiologic monitoring of patients...
appcast.io -
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