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Additionally, the Manager of Behavioral Health Revenue Management assists with the resolution of revenue generating issues and contract utilization related to both in-house systems, managed care, and Los Angeles County DMH system, with an emphasis on data interactions and data analysis as it relates to utilization management.
$80,000 - $95,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Possessing working experience in Payer or Provider operations (domain areas such as Medical Management, Population Health Management, Utilization Management, Provider Network Management, Value-Based Contracting, Provider Relations, Quality Improvement, Informatics, ACO operations, etc.
ExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Temporary/Relief Primary Care Physician shall agree that, as required by law, excluding emergency and primary care services, prior authorization must be obtained in writing from the respective CDCR/CCHCS Institution/Facility CEO/CME or designee, in accordance with CCHCS's Utilization Management Plan. Temporary/Relief Primary Care Physician shall complete and return all forms required by CDCR regarding treatment of patient/youth.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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The RN Case Manager is responsible for identifying said population via provider/clinic referral, utilization management referral, disease registry reporting mechanisms and patient self-referral.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Under the general direction of the Provider Network Operations (PNO) – Contracting Supervisor, the PNO Contract Coordinator is responsible for the managing and supporting the administrative and operational aspects of the PNO Contracting Team. This includes but is not limited to pre and post negotiation management, interfacing with PNO, Claims, Utilization Management (UM) and other departments.
ExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
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Medical management, Utilization management, and/or running a doctor’s office. Time management plays a key part in this role. Job Title:Grievance and Appeals Coordinator 1. Must have previous Grievance and Appeals exp.
ExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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The RN Case Manager is responsible for performing a high level clinical assessment and reassessment of acute care Inpatients for the purpose of performing utilization review, resource management and safe 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. Three years experience in public health nursing, acute care, case management and/or in-home health care required; minimum of 2 years of managed care experience in case management with focus in inpatient and/or outpatient ambulatory care preferred.
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Preferred two years in purchasing and GPO contract management, supply chain experience. Reviews the current group purchasing (GPO) contract portfolios, collaborates with and assists supply chain leadership to develop and maintain comprehensive clinical utilization protocols, product-standardization plans for requests, utilization, implementation and evaluation of clinical products within patient care areas.
$61,360 - $110,573 a yearFull-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Prior experience in utilization management processing authorization referrals also required. Coordinator II, Utilization Management page is loaded. Coordinator II, Utilization Management.
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Exemplary analytical cost management/cost control expertise including financial modeling, utilization of costing tools; SAP, Excel, and GAACP.Regulated utility exposure. Develop detailed budgets and tracking against Company financial systems, process & procedures, scope and change management required by the program.
$90,000 - $130,000Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Helps to achieve and maintain continuity of patient care by planning and exchanging information with other professionals within the hospital, long term care facilities, physician offices, medical groups, case management offices and others in the community.
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Ensures coordinated plans of treatment, customer focused care and cost effective utilization of services. Supervises unit(s) day- to- day clinical operations including practice standards, staffing, payroll, budgets, fiscal management, and quality improvement.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Working within the assigned Interim Housing team and aided by Performance Management Analysts, the Interim Housing Coordinator regularly engages with regional coordinators and provider agencies to actively manage the utilization of shelter beds and the timely delivery of services and referrals.
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Offer office education during the entire access process which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution.
Full-timeExpandUpdated 2 days ago
utilization management jobs in Los Angeles, CA
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