- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …benefits, encouraging individual growth and development, and incorporating our CARES values system into our daily operations, we are creating a workplace culture ... teamwork, and communication skills. Job Summary Leads the Quality and Risk Management Team through Process Improvement initiatives at the hospital. The Director… more
- Providence (Santa Monica, CA)
- …for quality, safe care from the Centers of Medicare and Medicaid Services ( CMS ). Reporting to the Manager or Director of Imaging, performs mammographic imaging of ... the breast to aid in the diagnosis and treatment of breast diseases. Prepare and assist in breast in compliance to established policies and procedures. Providence caregivers are not simply valued - they're invaluable. Join our team at Saint Johns Health Center… more
- LA Care Health Plan (Los Angeles, CA)
- …Department of Health Services (DHS), Centers for Medicare and Medicaid Services ( CMS ) National Committee Quality Assurance (NCQA) as well as LA Care guidelines. ... multi-departmental (Member Services, Product Network Operations (PNO), Claims, Utilization Management (UM), Pharmacy, Medicare Enrollment/Disenrollment, Sales and Quality … more
- Providence (Fortuna, CA)
- …healthcare, earning a 5-star rating from the Center for Medicare and Medicaid Services ( CMS ) as well as a Top Performing Hospital rating from the Partnership Health ... Plan's Hospital Quality Improvement Program in 2024. Join our reputable team and be part of a healthcare institution known for its clinical excellence and compassionate care. **About Providence** At Providence, our strength lies in Our Promise of "Know me,… more
- Highmark Health (Sacramento, CA)
- …range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in ... active case load of members in his/her panel that are enrolled in case management . The incumbent conducts outreach to members enrolled in case management … more
- Motion Recruitment Partners (Santa Monica, CA)
- …and maintaining APIs and backend services . Solid understanding of system design, data structures, and production reliability **Desired Skills & Experience** ... embeddings . Experience integrating AI with internal tools (Slack, Jira, CRM, CMS , etc.) . Knowledge of prompt engineering, evaluation, and monitoring strategies .… more
- Highmark Health (Sacramento, CA)
- …+ Ensure adherence to call center turn around time requirements associated with DPW/ CMS regulations. + Take necessary steps to perform a complete and accurate ... + Populate all authorization and denial information fields within the OnBase information system . + Enter all authorizations into the Argus IPNS information system… more
- Sutter Health (Oakland, CA)
- …glad you are interested in joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Bay **Position Overview:** The Physician Advisor (PA) is a key ... necessity, documentation best practices, level of care progression, denial management and compliance with governmental regulations and conditions of participation… more
- Sutter Health (Oakland, CA)
- … management development. * Executive level experience in a multi-facility/matrix management healthcare system strongly desired. * Demonstrated track record in ... Payroll **Position Overview:** Sutter Health is a leading not-for-profit healthcare system in Northern California, serving over 3.5 million patients through a… more
- LA Care Health Plan (Los Angeles, CA)
- Credentialing Specialist II Job Category: Provider Relations Department: Provider Data Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services( CMS ), California Department of Health Care Services (DHCS) requirements. This… more
Recent Jobs
-
Senior Director, HIV Treatment Marketing, ISL-LEN HCP Promotions
- Gilead Sciences, Inc. (Foster City, CA)
-
Manager of Emergency Services
- HCA Healthcare (San Jose, CA)
-
General Maintenance Technician III
- Amentum (Hillsboro, OR)