UM Case Manager

:Position: UM Case ManagerUM Case Manager implements the effective and best practices of Utilization Management. The UM Case Manager will provide high quality medical care review and service by appropriately applying the Milliman Care Guidelines, Health Plan and CMS/DMHC clinical guidelines to determine medical necessity for all authorizations.Position...

"Every person deserves compassion, dignity, and the safety of a place to call home."Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

p> The Managed Care Compliance and Audit Coordinator will assist with compliance and auditing functions of PHP/MSO (Management Services Organization), including, but not limited to, internal and external audit activities to the Claims, UM, Credentialing, CM functions, and quality improvement initiatives. This role will also be responsible for monitoring...

The Managed Care Compliance and Audit Coordinator will assist with compliance and auditing functions of PHP/ MSO (Management Services Organization), including, but not limited to, internal and external audit activities to the Claims, UM, Credentialing, CM functions, and quality improvement initiatives. This role will also be responsible for monitoring...

Job DescriptionThe Social Work Manager provides leadership for staff and accountability for the development of social services program assigned under Care Management operations. Oversight of these programs would include goals and objectives related to patient experience, personnel management, fiscal resources, performance improvement and interdepartmental...

p> The Clinical Social Worker, MSW interviews and evaluates patients and family members to identify social, emotional and economic factors which may interfere with obtaining maximum benefits from medical care; develops and implements a social work treatment plan to be offered to patients and family; selects and utilizes community resources as part of the...

The Social Work Manager provides leadership for staff and accountability for the development of social services program assigned under Care Management operations. Oversight of these programs would include goals and objectives related to patient experience, personnel management, fiscal resources, performance improvement and interdepartmental...

The Care Management NurseEducatorworks with the Care Management Director to facilitate quality improvement initiatives in the practice and learning environment to assist with staff and department development. Is responsible for department quality metric reports to demonstrate effectiveness of programs and performance in accordance with regulatory standards...

Responsibilities:ResponsibilitiesPerformance StandardAssessmentDoes the initial screening of all elective inpatient admissions related to: Appropriateness of admission Coordinates and supervises data and reporting needs. Provide timely discharge planning. Coordinates out-of-area transfers as well as third party contractual arrangements and supervise ground...

"Every person deserves compassion, dignity, and the safety of a place to call home."Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

Description:WILL CLOSE AFTER RECEIPT OF THE FIRST 150 APPLICANTS THAT INCLUDE A COMPLETED SUPPLEMENTAL QUESTIONNAIRE OR JUNE 4, 2024, WHICHEVER OCCURS FIRST.Examples of Duties:(Listed below are some of the basic duties for this position. For a complete listing of Essential functions, review the class specification)Performs the full array of residential,...

Job DescriptionJob DescriptionMedica Talent Group is excited to share this Temp to Hire opportunity with you!We are looking for an experienced Utilization Management LVN seeking a new exciting opportunity!For immediate consideration, Please submit your resume to: bchairez@medicatg.comFully Remote Must be located in CAMust have CA LVN license Pay:...

**_“Every person deserves compassion, dignity, and the safety of a place to call home.”_** - Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our...

“Every person deserves compassion, dignity, and the safety of a place to call home.” Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

"Every person deserves compassion, dignity, and the safety of a place to call home." Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

Job DescriptionJob Description“Every person deserves compassion, dignity, and the safety of a place to call home.”Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary...

Overview Under the general supervision of the case management Director acts as a patient advocate/case manager to hospital clients. An autonomous role that coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of quality and cost efficient patient outcomes. Looks for opportunities to...

Overview: Under the general supervision of the case management Director acts as a patient advocate/case manager to hospital clients. An autonomous role that coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of quality and cost efficient patient outcomes. Looks for opportunities to...

About Us: **VOALA** **_Helping Our Most Vulnerable Change Their Life Stories_** **PAY RATE**: $20.51-$21.59 PER HOUR **JOB SUMMARY AND PURPOSE** Case Manager Entry provides entry level case management services to clients classified as low acuity, serving on a team that is the central point of contact to coordinate services and care for assigned clients....

Job DescriptionJob DescriptionTitle: Program & Case ManagerReports to: Director of Community IntegrationDepartment: Individual Pathways (IP)Location: 15141 Whittier Blvd., Whittier, CA 90603FLSA Status: Exempt/BCompensation: $66,560 annually​​​​Program Hours: Monday – Friday 8:00 am to 4:30 pmSupervisory Responsibility: Community Integration...

“Every person deserves compassion, dignity, and the safety of a place to call home.” Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

“Every person deserves compassion, dignity, and the safety of a place to call home.” Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

Job DescriptionJob DescriptionWe are seeking a Therapist Case Manager to join our team! You will provide recovery-oriented rehabilitation services in group or individual settings.Responsibilities:Establish open lines of communication for individuals with mental or emotional issuesOffer assistance to individuals with substance abuse issuesProvide...

"Every person deserves compassion, dignity, and the safety of a place to call home." Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

"Every person deserves compassion, dignity, and the safety of a place to call home." Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...

Job DescriptionJob Description“Every person deserves compassion, dignity, and the safety of a place to call home.”Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary...

Job DescriptionJob Description“Every person deserves compassion, dignity, and the safety of a place to call home.”Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary...

Job DescriptionJob DescriptionOrtega Counseling Center seeks a full-time Vocational Counselor for our Whittier office. With over 20 years of combined experience, our commitment to injured workers aligns with our core values: positive attitude, willingness to learn, dependability, teamwork, and a customer-first approach. At OCC, our purpose is clear: helping...

Job DescriptionJob DescriptionBenefits:401(k) matchingBonus based on performanceHealth insuranceTraining & developmentOpportunity for advancementPaid time off Ortega Counseling Center seeks a full-time Vocational Counselor for our Whittier office. With over 20 years of combined experience, our commitment to injured workers aligns with our core values:...

Overview: **OVERVIEW OF POSITION**: Provides comprehensive case management, coordination, counseling, advocacy, linkage, and development of intervention plans using the START (Systemic, Therapeutic, Assessment, Resources, and Treatment) service model for individuals at risk for acute crisis, loss of residential placement, and/or individuals who are...

The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace the care for outcomes while meeting core measures within the appropriate level of care. The RN Case Manager provides discharge planning by collaboratively determining level of care needs...