- CVS Health (El Cerrito, CA)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... immersed in a culture of continuous improvement, with the goal of changing health care for the better. **Position Summary:** At CVS Health, we are focused on… more
- Ventura County (Ventura, CA)
- … as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments. + Performs other ... are expected to work at the full scope of their licensure providing clinical care with a decreasing amount of supervision commensurate with their experience. The… more
- WestCare Foundation (Fresno, CA)
- …staff development, education, and training activities. + Implement Quality Assurance and Utilization Review systems that monitor the effectiveness of the ... SUMMARY: Person in this position will be responsible for providing the clinical and administrative programmatic leadership and oversight for the program. Responsible… more
- Dignity Health (Los Angeles, CA)
- …skills in diagnosis and assessment, case management, treatment planning, psychotherapy, and utilization review . **Qualifications** + One year's experience in an ... Health, and the Department of Child and Family Services. Supervision by a licensed clinical supervisor in accordance with the rules and regulations of the Board of… more
- MTC (Calexico, CA)
- …+ Monitor all potential catastrophic illnesses. + Implement basic cost containment and utilization management for patient care and facility operations. + Comply ... in Calexico, CA** , we're looking for a dedicated doctor to bring compassionate care to a correctional setting where your expertise can truly change lives. If you're… more
- Cedars-Sinai (Beverly Hills, CA)
- …and providing professional development for pharmacists as it relates to patient care . This role demands a commitment to cooperation and collaboration among staff ... support multidisciplinary project teams focused on developing, delivering, and enhancing clinical and operational pharmacy services to improve the safe, effective,… more
- Humana (Sacramento, CA)
- …ABMS Medical Specialty + Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at Administrative… more
- Humana (Sacramento, CA)
- …+ Excellent written and communication skills + 5 years of established, post-residency clinical experience + Knowledge of the managed care industry including ... first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on… more
- WestCare Foundation (Fresno, CA)
- …meetings and presentations with referral agencies. + Implement Quality Assurance and Utilization Review systems that monitor the effectiveness of the program. ... the contract. + Heavy Documentation and knowledge of the Clinical Data System (CDS) data entry. + Responsible for...required. + Ability to establish relationships with Veteran, health care teams, and community service providers + Ability to… more
- WestCare Foundation (Fresno, CA)
- …staff development, education and training activities; + Implement Quality Assurance and Utilization Review systems that monitor the effectiveness of the program; ... 1 Families Fund Project. Responsible for the coordination of client care by collaborating with multidisciplinary professionals to provide and facilitate services.… more