Utilization Review Jobs in San Diego
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Search Results - Utilization Review Jobs in San Diego
Macpower Digital Assets Edge Private Limited (MDA Edge)-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 -
NCH Healthcare System-San Diego
Actively collaborates with utilization review team to facilitate and meet organizational and department goals. · Recognizes situations that require referral to quality or risk management and makes a timely referral. EDUCATION, EXPERIENCE AND QUALIFICATIONS...
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 -
Kaiser Permanente-San Diego
principles, practices, techniques and methods of utilization review/management, discharge planning or case management.
• Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.).
• Demonstrated ability...
Sharp HealthCare-San Diego
work. Knowledge of insurance, utilization review, scheduling requirements and support of front desk responsibilities. Able to operate and maintain department equipment.
Knowledge, Skills, and Abilities
• Demonstrated proficiency in clinical skill...
appcast.io -
Vivo HealthStaff-San Diego
and appropriate utilization in the most cost-effective, appropriate, and professional manner, which meets the expressed needs of patients and professional colleagues. The Physician Reviewer will be a part of the Health Services Department.
This department...
doccafe.com -
Sharp HealthCare-San Diego
utilization review, scheduling requirements and support of front desk responsibilities.
Able to operate and maintain department equipment.
Knowledge, Skills, and Abilities
• Demonstrated proficiency in clinical skill and nursing judgment.
Sharp HealthCare...
appcast.io -
KORE1 Technologies-San Diego
compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements.
Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services across the continuum of care...
smartsearchonline.com -
San Ysidro Health-San Diego
consultation.
• Actively participates in Quality Assurance activities of the Division with regard to treatment Utilization Review, medication monitoring, peer review, procedures and processes.
• Completes all required documentation in a timely fashion including...
appcast.io -
San Diego
and maintenance of incoming mail
• Timely response to Request for Authorization or referral for Utilization Review
• Consistent communication and claim reviews with all parties, including our Claims Services Account Manager in relation to brokers and policy...
icims.com -
Aurora San Diego-San Diego
insurance, 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...
workable.com -
Encompass Health-San Diego
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...
San Diego
the Patient Safety Reporting system.
• Facilitate medical staff drug utilization reviews (DURs) as deemed necessary.
• Exhibit basic competency in Microsoft Word, Microsoft Excel, and Microsoft PowerPoint and be able to type 40 words per minute.
• Assess...
icims.com -
Sharp HealthCare-San Diego
errors; Have the ability to proof work. Knowledge of insurance, utilization review, scheduling requirements and support of front desk responsibilities. Able to operate and maintain department equipment.
Knowledge, Skills, and Abilities
• Demonstrated...
appcast.io -
LVN – Dermatology Float Pool– SRS Del Mar – Day – FT (will travel to other clinics) - Eligible [...]
Sharp HealthCare-San Diego
utilization review, scheduling requirements and support of front desk responsibilities. Able to operate and maintain department equipment.
Knowledge, Skills, and Abilities
• Demonstrated proficiency in clinical skill and nursing judgment.
Sharp HealthCare...
appcast.io -
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