- Sharp HealthCare (San Diego, CA)
- …for non-approval. Rationale and all supporting documentation are provided to clinical reviewer for final determination.For approvals and denials, documents ... supporting rationale for non-approval. Provides all documentation and rationale to clinical reviewer for final determination. Documentation includes rationale… more
- Evolent (Sacramento, CA)
- …provides clinical rationale for standard and expedited appeals. . Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance...Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. . Aids and acts as… more
- Evolent (Sacramento, CA)
- …provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance...Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as… more
- Evolent (Sacramento, CA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with… more
- Evolent (Sacramento, CA)
- …Provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... to make a difference in patients' lives, in a non- clinical environment. You can enjoy better work- life balance...Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as… more
- Sharp HealthCare (San Diego, CA)
- …-REQUIRED **Preferred Qualifications** + 3 Years Experience in healthcare risk reduction/ quality /safety + Leadership experience + Certified Clinical Transplant ... CA Board of Registered Nursing; Bachelor's Degree in Nursing; Certified Clinical Transplant Coordinator (CCTC) - American Board for Transplant Certification… more
- Dignity Health (Northridge, CA)
- …for elevating standards and impacting patient lives? We're actively seeking a Quality Patient Safety Program Manager, Licensed. We rely on meticulous individuals. ... to accuracy and attention to detail will shine through as you review patient records, distill complex information into clear case summaries, and rigorously… more
- Dignity Health (Carmichael, CA)
- … improvement and patient safety training programs and coaches organizational clinical /service lines and operational/support departments in quality improvement ... local regulations; Joint Commission, etc.). **Licensure:** + Current State License in a clinical field. Five (5) years' experience in Quality Management can be… more
- UCLA Fielding School of Public Health (Los Angeles, CA)
- …and improving the performance of clinical care delivery across the eighteen clinical divisions in the DoM, including improving quality in both ambulatory and ... advance health for all. Reporting to the Senior Executive Clinical Vice Chair of the Department of Medicine, Tisha...initiatives in primary care, specialty care, inpatient care, peer review , and quality improvement education. The CQO… more
- Genesis Healthcare (Elk Grove, CA)
- …of the rehabilitation department, including oversight related to case management, quality improvement, care planning, clinical utilization, and patient ... Part-Time team members. + **Support for New Grads & Clinical Fellows:** Our Powerback Clinical Mentorship Program...Rehab supports the delivery of the highest standard and quality of rehabilitation services. 1. Fills in for the… more