We have other current jobs related to this field that you can find below
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Manager Utilization Management
2 weeks ago
Los Angeles, United States Kaiser Permanente Full timeJob Summary: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others...
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Manager Utilization Management
3 months ago
Los Angeles, United States Kaiser Permanente Full timeJob Summary: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others...
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Manager of Utilization Management
4 weeks ago
Los Angeles, United States Pivotal Placement Services, Inc Full timeManager, Utilization Management This is a full-time permanent opportunity with a large hospital system. Ensures cost-effective and quality patient care by appropriate utilization of resources. Provides direction to staff, including Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation, and others as assigned.We are looking for...
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Manager of Utilization Management
4 weeks ago
Los Angeles, United States Pivotal Placement Services, Inc Full timeManager, Utilization Management This is a full-time permanent opportunity with a large hospital system. Ensures cost-effective and quality patient care by appropriate utilization of resources. Provides direction to staff, including Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation, and others as assigned.We are looking for...
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Utilization Management Supervisor
4 days ago
Los Angeles, California, United States Lincoln Search Consultants Inc Full timeManager, Utilization Management Location: Los Angeles, CA, US Compensation: $165,000 - $175,000 + Bonus + SIGNING BONUS + Paid Relocation *RN Required* On-Call Rotation Required The Manager of Utilization Management oversees the daily functions of the Utilization Management Program within the designated Service Area or Medical Center. This role is pivotal in...
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Pharmacy Utilization Manager
5 days ago
Los Angeles, California, United States CEDARS-SINAI Full timePosition OverviewAt Cedars-Sinai, we understand that the work we do has a profound effect on the well-being of individuals. Our commitment to excellence is reflected in our six consecutive Magnet designations for nursing quality. By joining our team of distinguished healthcare professionals and utilizing cutting-edge facilities, you will have the opportunity...
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Clinical Utilization Management Advisor
5 days ago
Los Angeles, California, United States MartinLutherKingJrCommunityHospital Full timePosition OverviewThe Clinical Utilization Management Advisor (CUMA) serves as a vital link among hospital administration, clinical personnel, and support teams. This role encompasses part-time inpatient duties in utilization management and care coordination while also maintaining a portion of inpatient patient care responsibilities. The expectation is for...
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Utilization Management Physician Advisor
4 weeks ago
Los Angeles, United States MLK Community Healthcare Full timeJob DescriptionJob DescriptionJob DescriptionIf you are interested please apply online and send your resume to norozco@mlkch.orgThe expected schedule is a Wednesday, Thursday, Friday twice a month. POSITION SUMMARYThe Utilization Management Physician Advisory (PA) is a physician with a broad base of clinical experiences who acts as a liaison between the...
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Clinical Utilization Management Advisor
5 days ago
Los Angeles, California, United States Martin Luther King Jr. Community Hospital Full timePosition Overview:The Clinical Utilization Management Advisor serves as a crucial link among hospital management, healthcare professionals, and support teams. This role requires a physician with extensive clinical expertise who can effectively navigate the complexities of patient care.Key Responsibilities:1. Collaborate with clinical staff to ensure optimal...
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Los Angeles, California, United States MedPOINT Management Full timeJob 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...
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Pharmacy Utilization Manager
5 days ago
Los Angeles, California, United States Cedars-Sinai Full timeJob Overview At Cedars-Sinai, the work you engage in daily significantly influences the well-being of others. Every effort, detail, and moment counts. This culture of commitment and enthusiasm is part of what has earned us six consecutive Magnet designations for nursing excellence. Collaborating with a team of leading healthcare professionals and utilizing...
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Utilization Management Physician Advisor
4 weeks ago
Los Angeles, United States Martin Luther King Jr. Community Hospital Full timeThe Utilization Management Physician Advisory (PA) is a physician with a broad base of clinical experiences who acts as a liaison between the hospital administration, clinical staff, and support personnel. The PA position has part-time inpatient resp Physician, Management, Advisor, Medical Director, Patient Care, Staff, Healthcare
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Supervisor, Utilization Management RN
2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $102, Min.) - $132, Mid.) - $163, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get...
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Supervisor, Utilization Management RN
1 month ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2...
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Supervisor, Utilization Management RN
4 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2...
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Pharmacy Utilization Manager
4 days ago
Los Angeles, California, United States Cedars-Sinai Full timeJob OverviewAt Cedars-Sinai, the work you perform daily significantly influences the well-being of individuals. Every detail and moment is vital. Our culture of commitment and enthusiasm is one of the many reasons we have earned the prestigious Magnet designation for nursing excellence six times in a row. You will collaborate with a team of top-tier...
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Pharmacy Utilization Manager
4 days ago
Los Angeles, California, United States Cedars-Sinai Full timeJob OverviewAt Cedars-Sinai, the work you do is vital to the well-being of countless individuals. Our commitment to excellence and patient care is reflected in our six consecutive Magnet designations for nursing excellence. Here, you will collaborate with a team of leading healthcare professionals and utilize advanced facilities to make a significant impact...
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Los Angeles, California, United States MedPOINT Management Full timeJob 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,...
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Los Angeles, United States MLK Community Healthcare Full timeIf you are interested please apply online and send your resume to norozco@mlkch.org The expected schedule is a Wednesday, Thursday, Friday twice a month. POSITION SUMMARY The Utilization Management Physician Advisory (PA) is a physician with a broad base of clinical experiences who acts as a liaison between the hospital administration, clinical staff, and...
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Utilization Management Nurse Specialist RN II
1 month ago
Los Angeles, United States L.A. Care Health Plan Full timeUtilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11213 Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the...
Manager Utilization Management_
2 months ago
Job Summary: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others as assigned. Essential Responsibilities: + Assists in developing and maintaining policies and procedures for the Service Area or Medical Center related to Utilization Management. + Collaborates with the multi-disciplinary teams to plan and coordinate care across the continuum. + Coordinates and manages members care with non-KFH hospital facilities and providers. Identifies risk management and quality of care issues across the continuum. + Surfaces issues and any suggestions to the appropriate multi-disciplinary team members. + Manages transportation program to ensure appropriate utilization of resources which meet Health Plan guidelines and patient needs. + Assures compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements. + Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services across the continuum of care. + Assists in conducting statistical studies in utilization trends, patterns, and outcomes. + Hires, trains coaches, disciplines professional and clerical support staff. Basic Qualifications: Experience + Minimum three (3) years of experience in utilization management and discharge planning in an acute care setting to also include supervisory or management experience. Education + BSN or bachelors degree in healthcare related field such as management, health services administration. License, Certification, Registration + Registered Nurse License (California) Additional Requirements: + Demonstrated knowledge of operations and healthcare management; TJC, Title XXII, Medicare, MediCal and other local, state and federal regulations. + Knowledge of managed care operations. + Demonstrated interpersonal, negotiation, and management skills. + Good oral and written communication skills. + Must be able to work in a Labor/Management Partnership environment. Notes: + Rotating On-Call Weekends COMPANY: KAISER TITLE: Manager Utilization Management LOCATION: Los Angeles, California REQNUMBER: 1289920 External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
