- CVS Health (Sacramento, CA)
- …Management. - Refer all cases that do not meet applicable criteria or have a potential quality of care issue to a physician reviewer . - Identify and address ... with heart, each and every day. **This is a remote work from home role anywhere in the US...AHH delivers flexible medical management services that support cost-effective quality care for members. - This position consists of… more
- Cedars-Sinai (Beverly Hills, CA)
- …surpluses. Negotiates with sponsors the final payment due for account closeout. May conduct review and/or audits of clinical trial budgets. Serves as a resource ... trial budget. + Performs Medicare coverage analysis for clinical trials and collaborates with Institutional Review ...improve existing standard operating procedures related to budgeting and clinical trials finance. May identify quality and… more
- Zeiders Enterprises, Inc (San Diego, CA)
- Description Job Title: Remote Clinical Counselor **This position is fully remote and able to be supported from any location. However, candidates must be ... regardless of their location.** Shift: 7:00AM-5:30PM PT Summary The Remote Clinical Counselor works as a full-time...person (less than 10% annually). + Participate in quarterly quality assurance procedures to ensure that all clinical… more
- Stanford Health Care (Palo Alto, CA)
- …States of America) **This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in ... the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position requires strong … 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 ... clinical professionals. + A role that values innovation, continuous improvement, and clinical excellence. + **This position is 100% Remote and can be… more
- Providence (Mission Hills, CA)
- …prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission ... **Description** **RN Utilization Review at Providence Holy Cross Medical Center in...Credentialing Center (ANCC), which recognizes organizations that provide the highest- quality care. Only 9.96% of US hospitals earn Magnet(R)… more
- Providence (CA)
- …a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads for the Quality Department + Identify and ... reports issues related to clinical audits to determine potential areas for ...Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical… more
- UCLA Health (Los Angeles, CA)
- …The Public Mental Health Partnership (PMHP) is seeking to hire a full-time Clinical Quality Analyst (CQA) to conduct fidelity reviews for ACT/FACT teams ... fidelity reviews, quality assurance, quality improvement, and/or data-driven quality monitoring processes in clinical settings + Ability to work both… more
- Parexel (Sacramento, CA)
- …the trial team. + Medical responsibility as co-author for development of a robust Clinical Quality Monitoring Plan (CQMP) in line with the critical data, medical ... Clinical Study Physician. This is a fully remote role! Oncology, Inflammation or CMR preferred** The Study...trial CQMP (and its amendments). + Execution of relevant clinical quality monitoring for Study Physician using… more
- Bristol Myers Squibb (San Diego, CA)
- …therapeutic assets targeting Prostate Cancer. This role provides medical direction and high quality scientific and clinical knowledge to lead the strategy and ... studies + Contribute to writing of protocols, investigator brochures, clinical study reports, and review of other...+ Solid understanding of GCP and ICH guidelines. \#RayzeBio \#LI- Remote If you come across a role that intrigues… more