- Prime Healthcare (Encino, CA)
- …dedicated professionals committed to our core values of quality , compassion and community! Why Prime Healthcare? ... and reporting of patient test results, 2) follow the laboratory's established quality control policies and procedures in documenting all corrective actions taken… more
- Alameda Health System (Oakland, CA)
- …inpatient Labor and Delivery and acute GYN coverage in a Safety Net Healthcare system with a mission driven community of clinical providers. + Contribute to ... Nurse Midwives and Nurse Practitioners to support inpatient services. + Participate in the review of quality of patient care rendered in the Department of… more
- Ventura County (Ventura, CA)
- …with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + At least three ... positions. The Health Care Agency is a comprehensive healthcare system that encompasses the Ventura County Medical Center (VCMC),...and current knowledge of Quality Assurance, Utilization Review and Peer Review systems … more
- Stanford Health Care (Palo Alto, CA)
- …position ensures most appropriate and optimal revenue, diagnosis, procedure and quality information capture across all clinical encounters. Identifies meaningful ... Revenue Cycle and charge-generating departments, School of Medicine leadership, Clinical Operations leadership, Managed Care Contracting, Quality , Controller's… more
- Alameda Health System (Oakland, CA)
- …assigned patients; develops plans of care and discharge plans, monitors all clinical activities, makes recommendations for alternative levels of care, and identifies ... by each individual in the classification. + Coordinates all utilization review functions, including response to payor requests for concurrent and retrospective… more
- Alameda Health System (Oakland, CA)
- …committees and meetings to contribute to the development and implementation of quality improvement initiatives. + Oversees the secondary review process; actively ... multiple plans. + Generous paid time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role… more
- Alameda Health System (Oakland, CA)
- …personnel when replacements are necessary. 10. Participates in Performance Improvement/ Quality Control activities. 11. Performs basic clinical /technical skills ... Req #:42687-31693 + FTE:0.01 + Posted:August 26, 2025 **Summary** **SUMMARY:** Under clinical supervision of a RN or licensed physician/podiatrist, provides basic … 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 ... seek to connect the pieces of fragmented health care system and ensure people get the same level of...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 ... seek to connect the pieces of fragmented health care system and ensure people get the same level of...Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. . Aids and acts as… more
- Dignity Health (Bakersfield, CA)
- …health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups ... for ensuring the integrity of the adverse determination processes and accuracy of clinical decision making, as it relates to the application of criteria and… more