• Diagnosis Related Group Clinical Validation…

    Elevance Health (Walnut Creek, CA)
    … documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will ... make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (08/23/25)
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  • Clinical Resource Coordinator - Inpatient…

    Sharp HealthCare (San Diego, CA)
    …for use by themselves, Medical Directors, the Hospitalist Physician and/or Case Manager .Identifies and refer requests for review by higher level staff ... and employer business practices. **What You Will Do** To review more complex requests for medical care and services,...help facilitate care coordination services provided by the Case Manager . This position is responsible for the care and… more
    Sharp HealthCare (08/08/25)
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  • Clinical Fraud Investigator II - Registered…

    Elevance Health (Costa Mesa, CA)
    …guidelines and to identify opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to ... ** Clinical Fraud Investigator II - Registered Nurse and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (08/16/25)
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  • Pharmacy Manager

    Walgreens (San Francisco, CA)
    …of medications and drug interaction awareness. Offers preventive and clinical healthcare services, including immunizations, diagnostic testing, and patient outcome ... (eg patient consultation, medication management, drug therapy reviews, and perform clinical , or wellness services such as immunizations, diagnostic testing, and… more
    Walgreens (08/24/25)
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  • Manager Network Strategy and Contracting

    Dignity Health (Bakersfield, CA)
    …will be expected to work PST business hours.** **Position Summary:** The Manager , Network Strategy and Contracting reports to the Director of Provider Contracting. ... structures for operational clarity. - Collaborate with market leadership, finance, claims , and network teams to align contracting strategy with growth objectives.… more
    Dignity Health (07/31/25)
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  • Pharmacy Operations Manager

    Walgreens (Daly City, CA)
    …and federal laws/regulations allow, accountable for performing day-to-day non- clinical pharmacy operations, administrative activities; Ensures efficient pharmacy ... to customers' requests in a timely manner and answers non- clinical questions to ensure a positive customer experience. Models...efficient workflow. + At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records… more
    Walgreens (08/23/25)
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  • Mental Health Program Manager II…

    The County of Los Angeles (Los Angeles, CA)
    MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply  MENTAL ... HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Salary $132,439.68 -...of care and establishes and modifies program monitoring and review methods as necessary. Oversees audits and the implementation… more
    The County of Los Angeles (08/17/25)
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  • Manager , Risk Adjustment Coding Support

    Evolent (Sacramento, CA)
    …ensuring accurate and timely ICD-10 coding of claims via progress note clinical documentation review . + Ensure compliance and quality for all coding ... Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Manager , Coding Support Specialist** Evolent Care Partners is seeking a Risk Adjustment… more
    Evolent (08/14/25)
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  • Manager II, Facilities Operations…

    The County of Los Angeles (Los Angeles, CA)
    MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4762503) Apply  MANAGER ... in nearly every medical specialty and subspecialty. In addition, to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the… more
    The County of Los Angeles (06/05/25)
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  • Manager III, Facilities Operations…

    The County of Los Angeles (Los Angeles, CA)
    MANAGER III, FACILITIES OPERATIONS AND CRAFTS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4855820) Apply  MANAGER III, FACILITIES ... in nearly every medical specialty and subspecialty. In addition, to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the… more
    The County of Los Angeles (08/08/25)
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