- Ventura County (Ventura, CA)
- …cost-effective methods. Delegates performance of routine QA/UR activities to the QA/UR Nurses based upon guidelines approved by the medical director and Plan ... reasons many of the 802,983 residents call Ventura County " home ." Ventura has a diverse economic base from tourism...Review systems and programs + Direct patient care medical practice experience + Administrative experience + National Committee… more
- Humana (Sacramento, CA)
- …help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the… more
- Fresenius Medical Center (Murrieta, CA)
- …in implementing educational programs for PCT staff including contests and other team- based programs. + Assists in monitoring processes in the delivery of patient ... clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are...to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and… more
- Humana (Sacramento, CA)
- …part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice ... appeals. The Corporate Medical Director works on problems of diverse scope and...services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at… more
- HCA Healthcare (Riverside, CA)
- …21 states and the United Kingdom. We are looking for a Chief Medical Officer for our Riverside Community Hospital team where excellence creates excellence. ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… 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 ... non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology… more
- HCA Healthcare (Thousand Oaks, CA)
- …growth, we encourage you to apply for our Division Director of Graduate Medical Education opening. We promptly review all applications. Highly qualified ... Summary and Qualifications** This leader will need to be based at Riverside Community Hospital or Los Robles Regional... at Riverside Community Hospital or Los Robles Regional Medical Center. The leader **must be able** to attend… more
- Humana (Sacramento, CA)
- …team and healthcare organization. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review ... quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will...as well as a focus on collaborative business relationships, value- based care, quality metrics, population health, and disease or… 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 ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...MD review process to reflect appropriate utilization and compliance with… more
- HCA Healthcare (Riverside, CA)
- …satisfaction and personal growth, we encourage you to apply for our Medical Staff Credentialing Coordinator opening. We promptly review all applications. ... integrity. We care like family! Jump-start your career as a(an) Medical Staff Credentialing Coordinator today with Riverside Community Hospital. **Benefits**… more