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From admission to post-discharge, our Care Management team is there to assure care is appropriate, timely, cost-effective, and of high quality. Our Care Management team provides stream-lined coordination of patient care services to Hoag patients and families.
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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.
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The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management and utilization management. The goals of Case Management include the achievement of optimal health, access to services, advocacy, appropriate utilization of resources, collaboration with post-acute care providers to ensure patient's needs are met in the community, and to provide timely clinical reviews to payers.
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Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review/management, discharge planning or case management.
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2 years of experience in Case Management (Care Coordination or Utilization Management) or successful completion of the Transitions in Practice (TIP) program for Care Manager. At least 2 years acute care inpatient experience specific to utilization review, care coordination, & discharge planning.
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Cedars-Sinai placed in the top 20 on Newsweek’s “” list, which highlights hospitals that have excelled in the utilization of electronic functionalities, telemedicine, digital imaging, artificial intelligence and robotics.
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Utilization of Systems Engineering, PLM, and collaboration tools such as DOORS, JIRA, Confluence, Windchill, Creo, and SharePoint. Basic project management skills including labor estimating and schedule management.
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Review and monitor procedures for identifying quality of care issues and work collaboratively with multiple departments (Claims, Provider Network Operations, Utilization Management, Pharmacy) to appropriately address and resolve member and provider grievances.
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Reporting to the Director of Library Special Collections, the Team Leader for Collection Management is the Librarian who manages a team responsible for acquiring, accessioning, and cataloging special collections materials.
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The Design Director shall oversee design support management, scope of work management (contracts, cost and schedule), design review and approval, permitting, agency coordination support, and building information modelling (BIM) coordination.
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Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
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May also be responsible for identifying said population via provider/clinic referral, utilization management referral, disease registry reporting mechanisms and patient self-referral. The LVN Case Manager may provide daily care coordination, case management, coaching, consultation and intervention to patients with one or more chronic diseases.
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Build relationships with teams within Sales & Account Management and our closest stakeholders within Customer Success, Automation, Marketing, and Product. 5+ years of experience in a program management, product management and/or strategy & operations role at a technology company.
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Hyland OnBase Document Management System (ECM) OWP Management System (OMS) - subsystem of CBDS for Project Managers to submit current year’s progress report to Caltrans, entity’s funding administrator.
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License, Certification, RegistrationRegistered Nurse License (California)Basic Life SupportAdditional Requirements:Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review/management, discharge planning or case management.
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review utilization management jobs Title: sales representative in Inglewood, CA
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