- LA Care Health Plan (Los Angeles, CA)
- …Health department. Advanced knowledge of and experience in health plan quality assurance (especially related to claims , health services/population health ... Quality Configuration Assurance Analyst III Job Category: Information...root causes, etc. that impact member access to care, claims payments, etc.; and assessment and roll-out of key… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Sharp HealthCare (San Diego, CA)
- …timely resolution of provider issues.Escalates recurring or critical issues, such as quality -of-care issues, claims payment issues, or access issues to the ... of service and interaction is provided, including accurate and timely claims processing, issue resolution, performance recognition, education and training programs,… more
- Oura (San Francisco, CA)
- …to identify trends, drive root cause analysis, and measure the impact of quality improvements, directly contributing to reduced warranty claims . + Ensure ... community every day. We're looking for a Senior Sustaining Quality Engineer to join our Supply Chain team in...to inform decisions that reduce field failures, minimize warranty claims , and ensure ongoing improvements across the entire supply… more
- Banner Health (CA)
- …different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of acute care ... team that values growth and development! This is a Quality position, not a day-to-day coding production role but...to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials… more
- UCLA Health (Los Angeles, CA)
- …mandated billing guidelines. + Ensure compliance with Timely Filing guidelines and maintain quality control for paper claims . + Handle tracers, denials, and ... team and support accurate and timely processing of inpatient and outpatient claims . This role requires expertise in billing guidelines, customer service, and appeals… more
- Prime Healthcare (Chino, CA)
- …(2014-2022), Chino Valley Medical Center has been recognized nationally for its quality , including as among the 100 Great Community Hospitals by Becker's Hospital ... of dedicated professionals committed to our core values of quality , compassion and community ! Why Prime Healthcare? (https://cvmc.com/careers/why-prime-healthcare/)… more
- Prime Healthcare (Redding, CA)
- …an award-winning team of dedicated professionals committed to our core values of quality , compassion and community! Shasta Regional Medical Center, a member of Prime ... to promote an integrated program, which ensures the provision of the highest quality of health care. Collaborates with personnel responsible for safety and security… more
- Evolent (Sacramento, CA)
- …for the culture. **What You'll Be Doing:** Job Description **Analyst, Integration Quality ** Integration testing in the healthcare ecosystem requires complete end to ... - Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in… more
- CVS Health (Sacramento, CA)
- …an advocate and subject matter expert guiding the business by serving as a quality champion through measuring and monitoring the quality and effectiveness of ... with other departments to influence and promote change, to continually deliver quality service to both internal and external customers. Performs regular quality… more