• Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... physicians (MD, DO, or NP) to ensure documentation and coding accuracy of ICD-10 CM codes related to chronic...or more years of experience in providing education to clinical and non- clinical staff, required + Understanding… more
    UCLA Health (05/16/25)
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  • Clinical PPS Coordinator -Inpatient Rehab-…

    Sharp HealthCare (San Diego, CA)
    …PPS DataMaintains accuracy and completion of PPS Data.Completes chart reviews and inputs clinical information directly into the IRF PAI.Reviews coding by staff ... employer business practices. **What You Will Do** The Rehab Clinical PPS coordinator is responsible for ensuring accurate and...staff members of the interdisciplinary team for accuracy of coding and communicates any variances with the team. The… more
    Sharp HealthCare (06/26/25)
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  • Clinical Documentation Improvement (CDI)…

    Guidehouse (Escondido, CA)
    …Do** **:** The CDI Specialist is responsible for comprehensive secondary clinical chart reviews to identify potential missed opportunities for documentation ... clarification. In this role, you will collaborate closely with Coders, Coding Educators, Coding Quality Auditors, Case managers, Quality Department and Providers… more
    Guidehouse (07/25/25)
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  • Medical Director - Mid West Region

    Humana (Sacramento, CA)
    …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
    Humana (08/08/25)
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  • Medical Director- South Central

    Humana (Sacramento, CA)
    …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
    Humana (07/11/25)
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  • Senior Clinical & Population Health Analyst

    Highmark Health (Sacramento, CA)
    …and leads the design, development, execution, dissemination and interpretation of clinical and population health analyses, metrics and reports using clinical ... monitor actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects… more
    Highmark Health (07/22/25)
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  • Clinical Psychologist

    CVS Health (Sacramento, CA)
    …BCBA or BCBA-D credential + Experience with and knowledge of CPT and HCPCS coding guidelines and principles + Experience using clinical expertise in reviewing ... is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. Under the direction… more
    CVS Health (08/08/25)
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  • Clinical Resource Coordinator - Inpatient…

    Sharp HealthCare (San Diego, CA)
    …+ Other : Successful completion of Medical Terminology class, ICD-10 and CPT coding classes (or equivalent work experience). + Other : Successful completion of ... appropriate denial reason. Maintain mandated TAT for denials.Obtains and gathers clinical information from multiple sources including use of Sharp and/or Hospital… more
    Sharp HealthCare (08/08/25)
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  • Clinical Quality and Risk Liaison LVN

    Dignity Health (Bakersfield, CA)
    …in clinical quality measures, medical record documentation, and risk coding guidelines. - Collects, summarizes and trends provider performance data to identify ... work from home within the Bakersfield, CA region.** **Position Summary:** The Clinical Quality Liaison educates and supports providers and practice sites in… more
    Dignity Health (08/01/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Moreno Valley, CA)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
    Fresenius Medical Center (07/23/25)
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