Case Management Processor Jobs in California (NOW HIRING)

... processes to facilitate seamless transitions of care and optimize patient outcomes. The Case ... Management Coordinator assists with the management of members in PIH, Out of Network and SNF ...

Ensure case management policies and processes are consistently followed, educate staff on effective case management practices using GMLOS guidelines, improve multidisciplinary rounding functions ...

... processes to facilitate seamless transitions of care and optimize patient outcomes. The Case ... management of members in PIH, Out of Network and SNF facilities. PIH Health is a nonprofit ...

... processes to facilitate seamless transitions of care and optimize patient outcomes. The Case ... management of members in PIH, Out of Network and SNF facilities. PIH Health is a nonprofit ...

Implements and monitors processes to ensure optimal utilization of resources and appropriate ... Thorough knowledge of case management processes, utilization management practices, and care ...

... processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services. This position integrates national ...

Monitor and provide continuous quality improvement to the processes of basic, specialty and complex case management, including timely completion of Health Risk Assessments (HRA), documented ...

... processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services. This position integrates national ...

Monitor and provide continuous quality improvement to the processes of basic, specialty and complex case management, including timely completion of Health Risk Assessments (HRA), documented ...

Monitors case management processes and staff productivity to ensure medical necessity reviews are completed timely and accurately, payer communications are sent and authorizations or denials ...

Monitors case management processes and staff productivity to ensure medical necessity reviews are completed timely and accurately, payer communications are sent and authorizations or denials ...

Implement and monitor processes to prevent payer disputes * Develop and provide physician education and feedback on hospital utilization * Participate in management of post-acute provider network

Implement and monitor processes to prevent payer disputes * Develop and provide physician education and feedback on hospital utilization * Participate in management of post-acute provider network

The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management. Recognizing the patient's right to self-determination ...

The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management. Recognizing the patient's right to self-determination ...

... processes, including completing required case reviews and validating operational procedures ... Shadow Case Managers during participant interactions (in-person or virtual) to observe service ...

Their focus includes coordinating discharge needs, quality of care, and implementing the utilization management process for acute inpatients. Case Managers perform concurrent review and denials ...

... processes, including completing required case reviews and validating operational procedures ... Shadow Case Managers during participant interactions (in-person or virtual) to observe service ...

Their focus includes coordinating discharge needs, quality of care, and implementing the utilization management process for acute inpatients. Case Managers perform concurrent review and denials ...

Responsible for establishing and maintaining systems and processes that optimally provide for ... Case Management, Clinical and Management required. CCM certification preferred. License ...