- Sutter Health (Modesto, CA)
- …for Medicare and Medicaid Services (GR) Grouper (CMS) preferred. + Post-acute levels of care such as Home Health, Hospice, Advance Illness Management (AIM), and ... goals and objectives for ensuring the effective, efficient utilization of health care services. The PA will develop expertise on matters regarding physician practice… more
- Evolent (Sacramento, CA)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...health plans to ensure that prior authorization and financial coding stay accurate, compliant, and aligned with evolving needs.… more
- Sharp HealthCare (San Diego, CA)
- …needed for DME or other services for skilled nursing facility placement or home care .Ensures compliance with all applicable regulatory and health plan guidelines ... Qualifications** + 1 Year experience in the acute patient care , SNF, home health, or hospice settings....Plan contracts. + Understanding of the ICD and CPT coding . + Ability to identify medically necessary care… more
- Humana (Sacramento, CA)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs ... communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or… more
- Dignity Health (Grass Valley, CA)
- **Responsibilities** **Patient Care :** + Diagnose and treat various medical conditions. + Develop and implement comprehensive treatment plans. + Conduct thorough ... medical findings, diagnoses, and treatment plans. + Ensure compliance with coding and billing regulations. **Diagnostic Procedures:** + Order and interpret… more
- Sunnyside Nursing and Post-Acute Care (Torrance, CA)
- …goal to return home . Our team of qualified professionals provides compassionate care by: + Maintaining high medical integrity + Fostering a team spirit among ... to emails, and processing patient admission and discharge records. Requirements ICD-10 Coding (Preferred) Point Click Care (Preferred) Skilled Nursing Facility… more
- Sharp HealthCare (San Diego, CA)
- …care and services, including emergency room, inpatient admission, durable medical equipment, home care and other miscellaneous services for the efficient and ... practices. **What You Will Do** To review more complex requests for medical care and services, if part of the discharge plan, inpatient admission, skilled nursing… more
- Sutter Health (Emeryville, CA)
- …for Medicare and Medicaid Services (GR) Grouper (CMS) preferred. Post-acute levels of care such as Home Health, Hospice, Advance Illness Management (AIM), and ... goals and objectives for ensuring the effective, efficient utilization of health care services. The PA will develop expertise on matters regarding physician practice… more
- Humana (Sacramento, CA)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs ... communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or… more
- UCLA Health (Los Angeles, CA)
- …as required by operational need; there are no reimbursements for travel to " home office" location. Each employee must complete a FlexWork Agreement with their ... annually. Qualifications + Bachelor's Degree in Business Administration, Information Systems, Health Care or other related field required + Minimum of five (5)… more