- Sutter Health (Yuba City, CA)
- …of recent relevant experience. **SKILLS AND KNOWLEDGE:** + Knowledge of Drug Utilization Review Procedures and Therapeutic Drug Monitoring. + Demonstrated ... and proper allocation of Pharmacy resources to deliver quality patient care . Assures the timely and accurate preparation and distribution of pharmaceutical… more
- STG International (Corona, CA)
- …*Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... STGi is currently seeking a Primary Care Physician to provide services at our Community...and procedures and suggest improvements. *Assist the STGi Program Manager in implementation of Quality Performance Improvement Team (QPIT)… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... level of efficiency of operations and customer service while providing quality care to a designated patient population. **Required Qualifications** + Other :… more
- Sharp HealthCare (Santee, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... of efficiency of operations and customer service while providing quality care to a designated patient population. **Required Qualifications** + California Licensed… more
- Sutter Health (Tracy, CA)
- …professional staff is competent and sufficient to provide direct and indirect patient care and clinical services to the patient population of these units. Oversees ... The role is also a resource person for decision-making concerning patient care services, non-clinical services and ensures that hospital policies and procedures are… more
- Hospice Of San Joaquin (Stockton, CA)
- …about the Hospice philosophy and Hospice's services. QUALITY ASSESSMENT/IMPROVEMENT AND UTILIZATION REVIEW : Ensures compliance with the program plan, assuring ... + Follows the scope of practice when providing nursing care . + Makes recommendations to the Case Manager... of resources. + Participates in Quality Assessment/Improvement and Utilization Review activities as requested by administration.… more
- Stanford Health Care (Palo Alto, CA)
- …program team. + Develops and maintains professional relationships with insurance carrier's utilization 's review managers in order to complete authorizations in a ... knit, collaborative and supportive as they provide top tier care for patients. The Solid Organ Transplant unit allows...needed. + Performs other job-related duties as assigned by manager . **Education Qualifications** + High School diploma or GED… more
- Evolent (Sacramento, CA)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical… more
- Novo Nordisk (Long Beach, CA)
- …who need them most. At Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious chronic conditions such as obesity, ... relationships with physicians, pharmacists, nurses, and other key personnel in health care settings and major academic and large community health systems. The… more
- Highmark Health (Sacramento, CA)
- …drug utilization reports, and write drug monographs for Committee review to develop the Organization's Drug formulary and/OR provide recommendations for NDC ... not limited to: prior authorization, dose and duration edits, quantity limits, step- care edits, generic sampling medical policy review and development, member… more