Milliman jobs in Pasadena, CA

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RN Ambulatory Care Manager - VBSO Care Management
Keck Medical Center of USC - 50 reviews - Los Angeles, CA 90015
Knowledge of CM standards, UM standards, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, and Medicaid...
Referral Nurse (Registered Nurse or LVN)
The Referral Nurse is responsible for providing support to health network providers. Responsible to review Treatment Authorization Requests (TAR's)/Cerecons...
Easily apply
Out of Network Transfer Center Nurse Care Manager (Per Diem-...
In Milliman Care Guidelines. The Out-of-Network Transfer nurse works collaboratively with....

UM Case Management

PVHMC incl. Offsite Facilities - Pomona, CA
Current knowledge/use of Milliman Care Guidelines. 1 year of experience required....

Care/Case Manager

CEDARS-SINAI - 532 reviews - Los Angeles, CA
E) Process all appropriate services based upon covered benefits, health plan or Milliman Care Guidelines, or medical necessity:....

Social Worker - Emergency Room Per Diem Nights

Martin Luther King, Jr. Community Hospital - 14 reviews - Los Angeles, CA
Utilizes Milliman Care Guideline’s best practices to determine patient disposition. The Medical Social Worker is a skilled and experience professional License...

UM Case Manager

PVHMC incl. Offsite Facilities - Pomona, CA
Current knowledge/use of Milliman Care Guidelines. 1 year of experience required....

Care Connect Manager

Verity Business Services - Culver City, CA
Expert knowledge of Milliman Care Guidelines to make the determination if a patient meets admission criteria....

Care Connect Manager

Verity Health System - Culver City, CA
Expert knowledge of Milliman Care Guidelines to make the determination if a patient meets admission criteria....

Social Worker Inpatient PD Days (8am-430pm)

Martin Luther King, Jr. Community Hospital - 14 reviews - Los Angeles, CA
Utilizes Milliman Care Guideline’s best practices to determine patient disposition. The Medical Social Worker is a skilled and experience professional License...
Easily apply

DIRECTOR OF CASE MANAGEMENT

San Dimas Community Hospital - 17 reviews - Los Angeles, CA
6.Knowledge of Milliman Criteria and InterQual Criteria preferred. The Director of Case Management is responsible for the development of staff and systems to...

Clinical Documentation Specialist

ComforceHealth - Pomona, CA
Current knowledge/use of Milliman Care Guidelines. Three years acute hospital/clinical experience....
Easily apply

MANAGER-CASE MANAGEMENT-FULL-TIME-DAYS

CENTINELA HOSPITAL MEDICAL CENTER - 32 reviews - Inglewood, CA 90301
Knowledge of Milliman Criteria and InterQual Criteria preferred. Case Management is responsible for the development of staff and systems to effectively operate...
Transfer Center Care Manager RN (Per Diem Nights/Weekends -...
Out-of-Network Transfer Nurse Case Manager (OON) The Out-of-Network Transfer nurse works collaboratively with the SoCal SJH Ministries and the local area...
Care Manager, LVN
Proficiency in Milliman (Mcg) Care Guidelines. Care Management is a collaborative practice model including the patients, nurses, social workers, physicians,...