- Highmark Health (Sacramento, CA)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare appeal ... works with external resources to present final audit findings to department staff , physicians and appropriate individuals. (20%) + Validates the ICD-CM, ICD-PCS, CPT… more
- Alameda Health System (Oakland, CA)
- …for the recruitment, orientation, evaluation, counseling and disciplinary action of UM and administrative staff . + Serves as a content expert to staff ... post-acute and psych; three years of InterQual and/or MCG. Strong clinical nursing background. Required Licenses/Certifications: Valid license to practice as a… more
- Stanford University (Stanford, CA)
- …the complete range of cancer-related research, including basic, translational, clinical and population-based science. **Duties include:** + Independently conduct a ... regulations and all required trainings. + Supervise (either formally or informally) staff or students as needed, including oversight and direction on techniques, as… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …Unit Coordinator (BUC) collects and assimilates data and information for clinical /operational/financial decision making. The BUC will assist the Unit Director to ... an on-going basis. The BUC will organize work, set priorities, schedule staff , verify timecards, and effectively accomplish required duties with minimal supervision.… more
- Molina Healthcare (Long Beach, CA)
- …compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted ... during these visits is to proactively engage with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or CMS… more
- Sutter Health (Sacramento, CA)
- …capacity. The nurse works closely with hospital leadership, physicians, and other staff to assess real-time capacity data, predict future capacity challenges, and ... implement strategies to mitigate overcrowding. Strong clinical judgment, problem-solving, and communication skills are essential for ensuring smooth operations and… more
- WestCare Foundation (Fresno, CA)
- …key personnel; + Routinely Conduct site visits which consist of interviews with staff and clients, chart reviews, facility inspections for compliance in all areas. + ... and CARF requirements; + Conduct in-service trainings to WestCare California staff regarding, site visit, confidentiality regulations, treatment ethics, Client Bill… more
- Veterans Affairs, Veterans Health Administration (Mather, CA)
- …utilization. This service achieves optimal access to VAMC highly trained interdisciplinary staff with experience in the home setting and meeting all Joint Commission ... of patients into HCC program Provide direct patient care into home Make clinical decisions Interpret tests Care Coordination Timely notes adhering to medical … more
- Prime Healthcare (Anaheim, CA)
- …The Director of ICU is a Registered Nurse who assumes 24 hour administrative responsibility for the management of all critical care nursing service functions. ... of Patient Care Services or Administrator. Consults and communicates with staff , physicians, and administration both written and verbally on nursing issues… more
- Abbott (Pleasanton, CA)
- …injured employees to reach maximum health and productivity. Functions as a clinical case manager and coordinates an individual client's health care services across ... with management and the broad Environmental, Health and Safety staff to carry out mutual corporate objectives. + Acts...refer for further evaluation as necessary in accordance with clinical guidelines and protocols. + Assesses the broad spectrum… more