South San Francisco, CA - Jul 19
... NCQA, HIPPA, ERISA, EMTALA and all other applicable federal/state/local laws and regulations. Demonstrated strong communication and customer ... associated with various business lines (Medicare/KPSA, Commercial/KFH, Medi-Cal, Federal, etc.). SKILLS TESTING: N/A DUTIES: Utilization Management Performs daily preadmission, admission, and concurrent utilization reviews using guidelines, institutional policies/procedures, and other information to determine ...