- Molina Healthcare (Los Angeles, CA)
- …improvement activities. Responsible for overseeing delegated activities to ensure compliance with National Committee for Quality Assurance (NCQA), Centers for ... of experience with the following: UM, Prior Authorization, NCQA accreditation , and knowledge of InterQual / MCG guidelines. Excellent...successful in this role. Experience with Appeals, Auditing, and Compliance /Quality will be a good fit for this… more
- Molina Healthcare (Long Beach, CA)
- …improvement activities. Responsible for overseeing delegated activities to ensure compliance with National Committee for Quality Assurance (NCQA), Centers for ... with at least 4 years of UM experience, NCQA accreditation , and knowledge of InterQual / MCG guidelines. Excellent...with quick turnaround times. Experience with Appeals, Auditing, and Compliance /Quality will be a good fit for this… more
- Evolent (Sacramento, CA)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and… more
- Dignity Health (Merced, CA)
- …Service by monitoring and planning for budgets and expenses. Promotes medical staff compliance with regulatory and accreditation agencies by continuously ... period of time agreed upon by supervisor. Licensure: Certified Provider Credentialing Specialist (CPCS) achieved within one (1) year of employment **Where You'll… more
- UCLA Health (Pasadena, CA)
- … compliance with Department of Public Health, Joint Commission and other accreditation and regulatory agenciesThe University of California, Los Angeles is ... rotating neurology evening and weekend call schedule * Coordinate care with provider, specialist or ancillary services * Serve as role model for the profession and… more