You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on
WHO WE ARE NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help
Job Description:The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet
Job Description:The Complex Discharge Planner plays a vital role in managing patient flow from Concord Medical Center (CMC) and Walnut Creek Medical Center (WCMC) to post-acute care settings, including Skilled Nursing Facilities (SNFs), Residential Care Facilities
At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We
Position is FULLY REMOTE; CA RESIDENTS PREFFERED At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, functioning as both a care provider and
Utilization Management Coordinator I MSO Burlingame, CA 94010 Overview Salary Range $38.00 - $38.00 Hourly Education Level 2 Year Degree Description The Utilization Management Coordinator I functions under the direct supervision of a physician or Registered Nurse, performing utilization management (UM) and
Utilization Management Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi-Cal and Medicare populations. The Utilization Management Manager will report to the
Utilization Management Coordinator II MSO Burlingame, CA 94010 Overview Salary Range $39.69 - $45.10 Hourly Description The Utilization Management Coordinator II functions under the direct supervision of a physician or Registered Nurse performing utilization management (UM) and care coordination duties for the
Medical Director, Utilization Management The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical Director, Utilization Management will
Inpatient Case Manager The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care
Medical Director, Utilization Management Commercial Prior Authorization Review The Medical Management team ensures that Blue Shield of California (BSC) is on the cutting edge of utilization management reimagined to accelerate the development and sustainability of a value-based health care system in
Complex Discharge Planner The Complex Discharge Planner plays a vital role in managing patient flow from Concord Medical Center (CMC) and Walnut Creek Medical Center (WCMC) to post-acute care settings, including Skilled Nursing Facilities (SNFs), Residential
Promise Health Plan Medical Director The Healthcare Services team is committed to a single vision of transforming health care delivery for Blue Shield members. Within this framework, the Office of the Promise Chief Medical Officer (CMO)
Utilization Review Case Management Supervisor The Case Management Supervisor is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, and limited sales management. This is a
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired
When our values align, theres no limit to what we can achieve. At Parexel, we all share the same goal - to improve the worlds health. From clinical trials to regulatory, consulting, and market access, every
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united
BeOne continues to grow at a rapid pace with challenging and exciting opportunities for experienced professionals. When considering candidates, we look for scientific and business professionals who are highly motivated, collaborative, and most importantly, share our
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united