utilities manager - Huntington Beach, CA

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 guid ...

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 the team are properly trained to conduct medical necessity reviews on incoming Pre-Service/Prior-Authorization, Retr ...

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 ...

WearelookingforanexperiencedUtilizationManagementAppealsReviewNursetojoinourteam.TheidealcandidatewillhaveaprofessionallicensureasLVNorRNandatleasttwoyearsofexperienceinutilizationmanagement. · ...

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. · ...

This role enables associates to work virtually full-time with maximum flexibility and autonomy. The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. · Managing incoming calls or incoming post servic ...

The Utilization Management Appeals Review Nurse is responsible for conducting comprehensive clinical and regulatory reviews of hospital admission appeals. · This role ensures that appeal determinations are clinically appropriate, fully documented, · and compliant with CMS requir ...

This role enables associates to work virtually full-time with maximum flexibility and autonomy. · Managing incoming calls from clients needing mental health and substance use services. · ...

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. · ...

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 ...

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 ...

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. ...

The Supervisor, Utilization Management is responsible for management and oversight of staff who provide operational support and medical review on behalf of Medicare Advantage clients. This position ensures that all decisions made are accurate and complete and is responsible for d ...

We are seeking a Delivery Manager for one of our clients in Rosemead, CA. · ...

Trident Consulting is seeking an Project Manager for one of our clients in Pomona. · Strong understanding of project management core concepts and lifecycle methodologies. · Ability to manage multiple projects simultaneously with accountability for cost, schedule, and outcomes. · ...

+Job summary+About Altais: · At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences...+ ...

We are transforming senior care by providing an all-inclusive healthcare option to vulnerable seniorsOur Utilization Management LVN reviews authorization requests to ensure timely quality compliant cost-effective care. · Chart audits of items including consult summaries imaging r ...

We are transforming senior care by providing an all-inclusive healthcare option to vulnerable seniors. Our Utilization Management team ensures timely, quality, compliant and cost-effective care. · Chart audits of items including consult summaries and imaging results to determine ...