- CVS Health (Sacramento, CA)
- …Identify, research, analyze and document analytic leads or referrals to send for investigative review . + Review company clinical and payment policies to ... determine the impact of the scheme on Aetna business. + Keep current with new and emerging fraud, waste, and abuse schemes and trends through training sessions and industry resources. + Communicate with colleagues, verbally and in writing, findings related to… more
- Pfizer (South San Francisco, CA)
- …assigned clinical studies. + Provides therapy area/indication expertise in support of clinical review of clinical data - including CRF design, assistance ... and SCS + Support appropriate interpretation and communication of clinical trial data. + Review and approve submission level safety narrative plan. + Supports… 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 ... make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a...MD review process to reflect appropriate utilization and compliance with… more
- CVS Health (Sacramento, CA)
- …reporting to align local efforts with state and national quality goals. **Key Responsibilities** ** Clinical Review & Compliance** + Review and evaluate ... combines clinical expertise with quality improvement leadership, including clinical documentation review , Performance Improvement Projects (PIPs), ANE… 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 ... the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be a...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Sacramento, CA)
- …utilization management with collaborative engagement and innovation. **Core Responsibilities** + ** Clinical Review & Peer Collaboration** + Serve as the ... play a pivotal role in advancing value-based care models that prioritize clinical excellence, patient-centered outcomes, and system-wide impact. This role offers the… more
- Hologic (San Diego, CA)
- …teams, with a close connection to commercial counterparts, overseeing laboratory operations, clinical review , patient & client services, and Oncology R&D. This ... strategic and operational leadership for all aspects of laboratory operations, clinical review , patient & client services, and Oncology R&D. + Develop and… 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 process to reflect appropriate utilization and compliance 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 process to reflect appropriate utilization and compliance with… more
- Providence (Irvine, CA)
- …includes working with Clinical Care and Personalized health to ensure appropriate Clinical Review Committees for therapeutic class reviews as needed by the ... those served. This individual will function as a member of the Providence clinical senior executive leadership team, which has responsibility for the development and… more