Milliman jobs in Pasadena, CA

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Transfer Center Care Manager- Nights
Proficiency in Milliman Care Guidelines. Plus years of clinical experience in an HMO, medical group, affiliated model, hospital or medical office/clinic setting...
Sponsored by St. Joseph Health
RN, HBAT Care Manager
MemorialCare Medical Foundation - 51 reviews - Fountain Valley, CA 92708
Document in electronic health record all clinical supportive of medical necessity, length of stay and level of care according to Milliman Care Guidelines....
Sponsored by MemorialCare
RN Care Manager FT Shifts
Martin Luther King, Jr. Community Hospital - Los Angeles, CA
Utilizes Milliman Care Guideline’s best practices to determine patient disposition. Reporting to the Supervisor of Care Management, the Care Manager is...
Sponsored

SNF Case Management Coordinator

Network Medical Management - 4 reviews - Alhambra, CA 91801
Basic understanding of Milliman Care Guidelines criteria and continued stay at SNF, Acute Rehab and Sub-Acute unit, monitor LOS....
Easily apply

Director of Care Management

Martin Luther King, Jr. Community Hospital - Los Angeles, CA
Utilizes Milliman best practices to determine patient disposition. Reporting to the Chief Operating Officer/Chief Nursing Officer, the Director of Care...

Social Worker (MSW) Inpatient -FT Days (Care Management)

Martin Luther King, Jr. Community Hospital - Los Angeles, CA
Utilizes Milliman Care Guideline’s best practices to determine patient disposition. Interested applicants please send resume to Shall@Mlkch.org....
Easily apply

Utilization Review Nurse LVN/RN

Network Medical Management - 4 reviews - Alhambra, CA 91801
To implement the effectiveness and best practices of Utilization Management, the Clinical Specialist will provide high quality medical care review by...
Easily apply

Case Manager

Cedars-Sinai - 211 reviews - Los Angeles, CA  +1 location
Use Milliman and Interqual guidelines as necessary. Conducts case management on patients in the inpatient, intensive outpatient, residential care and Skilled...

CASE MANAGER

Coast Healthcare - 2 reviews - Lakewood, CA
Minimum 2 years case management, utilization / discharge planning experience in an IPA, Group, Hospital/Health Plan environment, or other qualifying clinical...

Social Worker - MLK Clinic

Martin Luther King, Jr. Community Hospital - 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...

Medical Director

Central Health Medicare Plan - Diamond Bar, CA 91765  +1 location
Hands on knowledge with CMS guidelines, Interqual or Milliman. Give guidance to hospital claims disputes and review of inpatient claims based on Milliman and...
Easily apply

Case Manager

Network Medical Management - 4 reviews - Alhambra, CA 91801
100% compliance in applying Milliman Care Guidelines criteria for admission and continued stay in acute care setting....
Easily apply

Clinical Nurse Auditor, Government Programs

Huntington Hospital - 115 reviews - Pasadena, CA
Utilization management experience in an acute care setting, working knowledge of InterQual or Milliman and Robertson medical necessity criteria and denials and...
LVN, Care Coordination Asst
Utilization Review required, using Milliman Care Guidelines or InterQual Guidelines required. The Care Coordination Assistant is responsible for Utilization...
Sponsored by MemorialCare
Case Manager - Case Management - CASE.MGMT.DIRECTOR - 12.19....
Knowledge of Milliman Criteria and InterQual Criteria preferred. **Bi-Campus position - oversees Garden Grove Hospital and Huntington Beach Hospital ***....
Sponsored by Prime Healthcare

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