Utilization Management - Orange County, CA

Astiva Health Inc is looking for a highly energetic and collaborative Utilization Management Manager to foster an environment of excellence in servicing Astiva Health's members. · ...

WearelookingforanexperiencedUtilizationManagementAppealsReviewNursetojoinourteam.TheidealcandidatewillhaveaprofessionallicensureasLVNorRNandatleasttwoyearsofexperienceinutilizationmanagement. · ...

The Utilization Management (UM) Clerk will assist in the clerical support to the UM department staff. · Process incoming and outgoing mail for the UM Department. · Maintains inventory of office supplies at a level necessary for proper functioning of the department. · ...

Provide subject matter expertise in support of its OMS implementation at CLIENT. · Assist with system logic, processes, and data particularly as it relates to OMS-related projects, · ...

This role enables associates to work virtually full-time in CALIFORNIA, with the exception of required in-person training sessions. · The Utilization Management Representative II is responsible for conducting service coordination functions for a defined caseload of individuals. ...

This is an outstanding career opportunity for a Utilities Manager to join the Public Works Department in Huntington Beach. · ...

Provide subject matter expertise in support of its OMS implementation at CLIENT (OpenGrid Network). · ...

The Opportunity: The UM Coordinator will support the Utilization Management function of multiple IPAs in the Inland Valley area to proactively monitor utilization of services for patients. · ...

The UM Nurse Manager is responsible for providing strategic and operational leadership to the day to day function of the Utilization Management Team. Ensures that staff achieves performance goals while adhering to applicable internal and external policies, procedures rules and gu ...

The UM Nurse Manager is responsible for providing strategic and operational leadership to the day to day function of the Utilization Management Team.The role involves ensuring compliance with timeliness, documentation, notification and review quality standards based on Federal St ...

This position is Per Diem and will work 8-hours, Day shifts. · Under the supervision of Regional Director of Care Management. · ...

+Job summary · Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. · ResponsibilitiesProviding support to the Care Management team who coordinates care. · ...

The Senior Utilization Management Assistant will provide support to the Care Management team in coordinating care. This role works closely with a healthcare team and performs complex tasks related to patient assessment and management. · Provide support to the Care Management team ...

Under the supervision of Regional Director of Care Management, the Utilization Management Coordinator is responsible for providing support to the Care Management team who coordinates care. This position works closely as a healthcare team member and performs complex tasks related ...

This role enables associates to work virtually full-timeThe Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review,Managing incoming calls or incoming post services claims work.Determines contract and bene ...

Job summary · Enables associates to work virtually full-time with maximum flexibility and autonomy. Promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.ResponsibilitiesManaging incoming calls or incoming post ...

This role enables associates to work virtually full-time with maximum flexibility and autonomy. · Managing incoming calls or post services claims work. · Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prio ...

Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. · ...

This position works closely as a healthcare team member and performs complex tasks related to the overall team functions and activities identified during the initial and ongoing assessment and management of patients. · *5 years - Hospital, clinical setting or healthcare related f ...

A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options offers superior clinical mental health and substance use disorder management. · Requires HS diploma or equivalent and a minimum of 2 years customer service experie ...