- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical ... in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG)… more
- Evolent (Sacramento, CA)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Sacramento, CA)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Sacramento, CA)
- …and provides clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...MD review process to reflect appropriate utilization and compliance with… 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 ... reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Sacramento, CA)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Field Medical Director, Physical Medicine and Rehab you will be...MD review process to reflect appropriate utilization and compliance with… more
- Humana (Sacramento, CA)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer- based review of moderately complex ... Medicare Advantage and Managed Medicaid. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- The County of Los Angeles (Los Angeles, CA)
- …activities that involve various healthcare sectors to include Ambulatory Surgery Centers, Home Health/Hospice and EMS Provider. + Develops medical surge ... SENIOR NURSING INSTRUCTOR (EMERGENCY MEDICAL SERVICES) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3309230) Apply SENIOR NURSING… more
- Ventura County (Ventura, CA)
- Field Based Psychiatric Technician - Behavioral Health (Regular & Per Diem) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4901938) Apply ... Field Based Psychiatric Technician - Behavioral Health (Regular & Per...to psychiatric patients. Responsibilities include delivering both psychiatric and medical care within the scope of practice as a… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services… more