- Dignity Health (Rancho Cordova, CA)
- …**Position Summary:** This position is responsible for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate ... the continuum of healthcare. Responsibilities may include: - Concurrently review patient's records to collect data to...services using clinical judgment and established guidelines. Refer to Medical Directors for review depending on case… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and… more
- UCLA Health (Los Angeles, CA)
- …including inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health ... include: + Travel to various clinic sites and schedule and conduct medical record and facility site audits + Conduct thorough facility site reviews and… more
- Centene Corporation (Sacramento, CA)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. +...by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA… more
- The County of Los Angeles (Los Angeles, CA)
- …direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of ... for and the effective conduct of the system to review patients' medical charts to ascertain the...SECURITY NUMBER: Please include your Social Security Number for record control purposes. Federal law requires that all employed… more
- The County of Los Angeles (Los Angeles, CA)
- …authorization for the issuance of denial letters. + Reviews, retrospectively, utilization review records for completeness, use of appropriate codes, correctness ... physician advisor for follow up on referrals. + Reviews, retrospectively, Utilization Review Records for completeness, use of appropriate codes, correctness of… more
- Sumitomo Pharma (Sacramento, CA)
- …Initiated Study and Collaborative Research program. + Provide detailed and compliant medical review and approval of external resources, communications, and ... as appropriate. + Capable of translating brand goals and objectives into actionable medical and scientific strategies. + Proven track record of detailed,… more
- Centene Corporation (Sacramento, CA)
- …compliance. + Performs a clinical review of post-care services by reviewing medical records against guidelines and clinical research criteria to determine if ... at the most efficient and effective level + Reviews medical records for medical necessity...of care issues, and if identified, refer to the Medical Director or provider for review and… more
- Humana (Sacramento, CA)
- …management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present ... health topics to the clinical operations team and healthcare organization. The Medical Director's work includes computer based review of moderately complex… more
- VCA Animal Hospitals (Sacramento, CA)
- … in such circumstances and revises protocols when appropriate. + Along with the RMD, medical record review of associate DVM's as needed. + Determines in ... practices in Northern California, is looking for a **Specialty Medical Director** to lead our growing team. VCA SVRC...performs yearly associate DVM reviews + Participates in yearly review of lead technician (s) with HM + Supports… more
Recent Jobs
-
Certified Clinically Advanced Nutrition CRD - Endocrinology
- Mount Sinai Health System (New York, NY)
-
Associate Director | Commercial Financial Services
- Guidehouse (New York, NY)
-
Clinical Care Assistant (CCA)
- Brockton Hospital (Brockton, MA)
-
Substitute Teachers/Teacher Assistant Roles Affton
- Kelly Services (St. Louis, MO)