Outpatient UM Clinician

Job DescriptionJob DescriptionSummaryThe Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead...

Job DescriptionJob DescriptionSummaryThe Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead...

Job DescriptionJob SummaryThe Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead Coordinator...

Job DescriptionJob DescriptionThe Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead...

Job DescriptionJob DescriptionThe Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead...

Health Plan RepresentativeThe Health Plan Representative serves as the primary liaison between the Outpatient Utilization Management (UM) team and Health Plan officials. This position is tasked with overseeing referral inquiries assigned to the Health Plans, ensuring that all necessary documentation is submitted and diligently following up until a conclusive...

Job OverviewThe Outpatient Utilization Management Coordinator serves as the primary liaison between the Outpatient Utilization Management (UM) team and Health Plan representatives. This position is responsible for managing referral requests directed to Health Plans, including but not limited to tertiary care, durable medical equipment, and pharmacy services,...

Job OverviewPosition: Outpatient Utilization Management Specialist at MedPOINT ManagementRole SummaryThe Outpatient Utilization Management Specialist is essential in enhancing communication between Managed Services Organizations (MSO), Independent Physician Associations (IPA), and members to guarantee seamless member care. Key responsibilities include...

Your Role The Behavioral Health Utilization Management team performs prospective, concurrent, retrospective utilization reviews and first level determination approvals for members using BSC evidenced based guidelines, policies, and nationally recognized clinal criteria across multiple lines of business. The Licensed Clinician, Senior, will report to the...

Job DescriptionJob DescriptionThe Web Inquiry Support Coordinator provides effective web communication between MSO, IPA providers, health plan representatives to coordinate member care. Communication to include accessibility to care, validating contract, modification request and ensuring timeliness standards are met. The Web Inquiry Support Coordinator...

Job SummaryMolina Healthcare Services (HCS) is seeking a skilled Care Review Clinician, Prior Authorization to join our team. As a key member of our healthcare team, you will work closely with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum.Key...

Job DescriptionJob DescriptionThe Health Plan Liaison is the main point of contact between Outpatient UM team members and Health Plan personnel. This role oversees referral requests that are delegated to the Health Plans (i.e. tertiary, DME, pharmacy, etc.), from the initial provider request until the final decision from the Health Plan is made. Reporting to...

Job DescriptionJob DescriptionReporting to the Supervisor, Client Support Center and VP, Quality Management, the Clinical Liaison is responsible for assisting client support TMs with IPA approval workflows that require escalation, expedited handling or additional clinical information to finalize authorizations. Duties and Responsibilitieso Assist Client...

Job Title: RN ENT/OutpatientJob Location:8635 West Third Street #590WLos Angeles, CA 90048Description:\*\* This is an administrative role and will rarely include patient care\*\*Primary Location: 8631W. 3rd Street, Los Angeles, CA 90048Float Location: 960 E. Green Street, Pasadena, CA 91105Position / Specialty: RN ENT/OutpatientYears of experience REQ: 2...

Refresh Center, part of the Optum family of businesses, is seeking a Licensed Clinician / Therapist to join our team in Pasadena, CA. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Behavioral Care Team, you'll be an integral part of our vision to make healthcare better for everyone....

*Address: 11800 Wilshire Boulevard Suite 200 & Suite 300, Los Angeles, CA 90025 **Duration: 13 weeks **Position / Specialty:** Oncology - Outpatient LVN* Years of experience REQ: 1+ year in an outpatient setting* First-timers accepted: Yes* Weekend REQ: Few weekend call* Certs REQ: BLS and IV certified* Is on-call REQ? No* Will the clinician float within the...

Job DescriptionJob DescriptionAbout Us:SCADPSouthern California Alcohol and Drug Programs, Inc. (SCADP) was established in 1972 in a grassroots effort by community volunteers seeking alternatives for individuals with substance use disorder (SUD). SCADP is a 501 (c) (3) non-profit organization providing residential and outpatient substance abuse treatment.JOB...

Job OverviewThe Web Inquiry Support Specialist plays a crucial role in facilitating effective online communication among MSO, IPA providers, and health plan representatives to ensure seamless member care coordination. This position involves addressing accessibility to care, validating contracts, processing modification requests, and adhering to established...

Job SummaryWe are seeking a highly skilled and compassionate Lead Clinician to join our team at Los Angeles Christian Health Centers. As a key member of our medical team, you will be responsible for providing exceptional patient care, supervising other healthcare professionals, and contributing to the overall success of our organization.Key...

Job DescriptionJob DescriptionSummaryOversees the higher level of care cases and the process and the management of our inpatient transplant cases. Will be responsible for answering any questions the inpatient nurses might have during their shift with the direction of the Lead La Care Shared Risk Nurse, and Medical Directors. Provides overall coordination in...