Utilization Review Jobs in San Diego
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San Diego (CA)
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Search Results - Utilization Review Jobs in San Diego
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 -
Center For Discovery-Del Mar, 17 mi from San Diego
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 -
Molina Healthcare-San Diego
Education
Bachelor's Degree in Nursing
Preferred Experience
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
Effective verbal and written...
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 -
Alameda Health System-San Diego
Summary
Role Overview:
The System Educator of Care Coordination and Utilization Review is responsible for developing, implementing, and maintaining education and training programs across the organizations care coordination and utilization...
tiptopjob.com -
Casa Palmera-Del Mar, 17 mi from San Diego
orientated and psychoeducation groups daily/weekly.
Provides utilization reviews to insurance companies, providing appropriate clinical information to obtain initial authorization and continuing stay authorization, as necessary.
Is appropriately accessible...
resume-library.com -
Molina Healthcare-San Diego
driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
Preferred Experience
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization...
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
when needed. Ensures adherence to internal policies 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...
Northeast Healthcare Recruitment, Inc. (NEHCR)-San Diego
healthcare quality, cost, and outcomes.
7. Identify and develop innovative opportunities to enhance effectiveness and quality.
8. Full Time, Call 1:4
9. 100% Virtual
10. Apply Criteria, Utilization review
Requirements:
1. MD or DO with Board certification...
appcast.io -
San Diego
Professional Utilization Review (CPUR) program
• Certified Case Manager (CCM) issued by the Commission for Case Manager Certification.
--OR--
• Possess two (2) years of full-time broad based registered nurse experience in a utilization management review...
icims.com -
South Shore Health System-San Diego
The Medical Director actively participates in and oversees the Quality Assurance, Compliance and Utilization Review Programs.
• The Medical Director maintains appropriate clinical standards and follows the guidelines established by the organization’s Policy...
appcast.io -
Sharp HealthCare-San Diego
Have the ability to type a minimum of 30 words per minute with 0-2 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...
appcast.io -
The Nonprofit Partnership-San Diego
and administrative functions.
15. Oversees and participates in the referral management process and utilization review.
16. Maintains a clinical practice one day per week (20% time), treating patients within the scope of licensure and organizational protocols.
17. ..
appcast.io -
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