- 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
- Molina Healthcare (San Bernardino, CA)
- …actions as needed. * Fosters clinical practice guideline implementation and evidence- based medical practices. * Utilizes information technology and data ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ...for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership and… 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
- Hologic (San Diego, CA)
- …certainty and peace of mind. Hologic Oncology Services is seeking a field based Medical Science Liaison (MSL) responsible for bringing together and communicating ... popular business software desirable **Additional Details:** + Work is performed in a home office, medical office and conference environments + Regularly required… more
- City and County of San Francisco (San Francisco, CA)
- …and substance use treatment services. Under general supervision, the Medical Social Work Supervisor oversees recruitment, training, supervision, and evaluation ... consultation and supervision on complex cases. Additionally, they coordinate medical social services programs, perform therapy, handle administrative duties, and… more
- UCLA Health (Santa Monica, CA)
- …more than 270 community- based clinics throughout Southern California. We are also home to the David Geffen School of Medicine, a highly respected leader in the ... development of breakthrough medical research and outstanding clinical professionals. If you're looking to experience greater challenge and fulfillment in your… more
- Humana (Sacramento, CA)
- …Humana's Primary Care Physician Recognition programs, including Model Practice, Patient-Centered Medical Home , and Quality Recognition programs across multiple ... our caring community and help us put health first** The Senior Value- Based Programs Reporting Analyst builds templates, standard documentation, policy and protocol,… more
- Ventura County (Ventura, CA)
- Medical Surgical and Telemetry Registered Nurse II -...4 - 2029 + Certification Pay: $0.813 per hour based on scheduled work week hours for each qualified ... Pool -Regular and Per Diem Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4935075) Apply Medical Surgical and Telemetry Registered Nurse II - Float… more
- Fresenius Medical Center (Colton, CA)
- …functions as the Home Therapies Program Manager to oversee the facility's Home Therapies Program. + Maintains integrity of medical and operations records and ... **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Dignity Health (Bakersfield, CA)
- …backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer consultations, appeals and grievances and other ... **Job Summary and Responsibilities** This position will be hybrid work from home (** **within California** **) and in-clinic, requiring up to 50% travel to provider… more