- Centene Corporation (Sacramento, CA)
- …CA license.** **Must have** **2-4 years related** **experience in UM- Concurrent Review . 2+ years of acute care experience required. 10% Travel required.** ... care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions...to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical … more
- Datavant (Sacramento, CA)
- …evolve the product vision, strategy, and roadmap for the Prospective Suspecting and Concurrent Review solutions within Datavant's Clinical Insights Platform ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...Background in working with provider documentation teams, coders, or concurrent review vendors. + Clinical … more
- Centene Corporation (Sacramento, CA)
- …were administered with quality, cost efficiency, and are within compliance. + Performs a clinical review of post- care services by reviewing medical records ... providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations +… more
- Sharp HealthCare (San Diego, CA)
- …position, and employer business practices. **What You Will Do** Perform admission and concurrent review of patients, based upon needs regardless of payor ... patients.Interfaces with Business Office regarding ongoing certification of stay.Provides concurrent and retro UR reviews to Review Organizations.Identifies… more
- The County of Los Angeles (Los Angeles, CA)
- …delivery of patient-specific pharmacotherapeutic or pharmacokinetic services in specialized medical care areas. Clinical Pharmacists work closely with healthcare ... exercise an advanced, expert level of knowledge and skill in pharmaceutical care to provide the most specialized clinical pharmacy services, characteristically… more
- The County of Los Angeles (Los Angeles, CA)
- …the health of our patients and our communities by providing extraordinary care . DEFINITION: Provides specialized clinical pharmacy services in the delivery ... Units (MICU, SICU, NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care , Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug… more
- Guidehouse (Escondido, CA)
- …and is reflective of current CMS or other regulatory standards. + Conducts daily, concurrent review of inpatient records on assigned unit(s) to ensure complete ... **:** The CDI Specialist is responsible for comprehensive secondary clinical chart reviews to identify potential missed opportunities for...Communicates to the CDI Coordinator when volume of daily review assignments is too high or low so that… more
- LA Care Health Plan (Los Angeles, CA)
- …Actively participates in the discharge planning process, including providing clinical review and authorization for alternate levels of care , home health, ... of concurrent reviews. Duties Provides the primary clinical point of contact for inpatient acute care...including, but not limited to, placement (with level of care ) criteria (MCG, InterQual), concurrent review… more
- Stanford Health Care (Palo Alto, CA)
- …improvement activities by identifying opportunities for improvement in such areas as clinical outcomes, utilization of resources and concurrent data collection; ... payers to assure reimbursement for patient services/procedures. Communicates with review organizations/payers to provide requested clinical and psychosocial… more
- Sharp HealthCare (San Diego, CA)
- …decisive manner. + Able to manage difficult peer situations arising from medical care review . + Appreciation of cultural diversity and sensitivity towards target ... and responds to accrediting and regulatory agency feedback. + Supports pre-admission review , utilization management, and concurrent and retrospective review … more