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PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The Utilization Management (UM) RN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines.
$40.28 - $66.78 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Conducting weekly aquatics update meetings with COO and GMs to report on revenue status and review status of lead generation and follow up. Set and strive to achieve goals and objectives in pursuit of making the LBYC youth program the best in LA County.
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The Mental Health Clinician will operate in accordance with all regulations and standards of the State of California Board of Behavioral Science Examiners the Los Angeles County Department of Mental Health and the Department of Child and Family Services.
$30.49 - $44.2 an hourFull-timeExpandApply NowActive JobUpdated 30 days ago - UpvoteDownvoteShare Job
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Draft, review, revise, and negotiate clearance agreements, location agreements, vendor agreements, equipment rental agreements, animal handler agreements, non-disclosure agreements, and other production-related agreements.
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Responds to phone calls from the elected prosecutor, administrative staff, fellow prosecutors, or law enforcement investigators at the local, county, state, federal and, on occasion, international level to discuss legal issues regarding any case involving the Macomb Prosecutor's office.
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Duties Focus on quality review of grievance and appeals cases for all LOB to identify areas of improvement to assist the department in increasing positive audit outcomes and improved Customer Service to L.A. Care’s membership.
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Acts as a clinical liaison, per their specialty, with outside agencies such as County CCS, non-plan facilities, outside providers, employers and/or workers compensation carriers and third party administrators.
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Provide input to encroachment permit submittals which impact or concern the Orange County Flood Control District (OCFCD), research OCFCD rights of way and facilities, review impacts on OCFCD, identify any need for new agreement, temporary construction easement, right of entry, consent, license, and easement.
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For charge capture and reimbursement improvement using contract and denials management tools/techniques, random reviews (including payment accuracy reviews), review of medical records and claims data.
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Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of utilization review/management, care coordination, transfer coordination, discharge planning or case management.
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Primary Duties and ResponsibilitiesWorking under the supervision of the Data Manager, the primary role of the Quality Assurance Associate is to: Conduct ongoing client file review and reconciliation on Clarity HMIS.Develop and update monitoring checklists in concert with QA Manager or Director so as to strategically identify items to review in each file.
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Applications Team Receive training and guidance on the application process for Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), and Cash Assistance Program for Immigrants (CAPI) Works directly with clients to process, complete, and submit initial SSI, SSDI applications to SSA and/or CAPI applications to DPSS. Collaborates with CBEST Legal Services providers for quality assurance review of applications.
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Experience drafting policy and providing training to clinical staff for current LA County DMH documentation and Medi-Cal procedures. Audit Assists with preparing for State Audit Reviews and LA County DMH Program Reviews.
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Facilitates and supports program leaders to be effective in adopting and implementing annual employee life-cycle processes such as recruitment and hiring, onboarding, goal setting, annual performance appraisal/review procedures, talent reviews and creation of development plans.
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Company DescriptionSocial Model Recovery Systems (a non-profit 501(c)3 California corporation) provides direct treatment services (at 11 locations in Los Angeles County) for those whose lives have become unmanageable due to alcohol and other drug use and/or whose mental health issues are interfering with leading productive lives.
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county review jobs in Glendale, CA
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