- Dignity Health (Oxnard, CA)
- …and children and implements department policies and procedures. Measurement: Feedback, Medical Record Review , Observation. + Advance Directives: Consistently and ... chart, and refers questions to Chaplain Services. Measurement: Documentation, Feedback/ Observation, Medical Record Review . + Advocacy, Patient: Acts as the… more
- Elevance Health (Los Angeles, CA)
- …benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review … more
- Dignity Health (Camarillo, CA)
- …and children and implements department policies and procedures. Measurment: Feedback, Medical Record Review , Observation. + Advance Directives: Consistently and ... chart, and refers questions to Chaplain Services. Measurement: Documentation, Feedback/ Observation, Medical Record Review . + Advocacy, Patient: Acts as the… more
- Robert Half Accountemps (Manhattan Beach, CA)
- …* Generate reports and documentation related to credentialing activities for internal review . Requirements Medical Credentialing, Medical Collections, HMO, ... Description We are looking for a detail-oriented Medical Collector Credentialing Specialist to join our team...to join our team in Manhattan Beach, California. The Medical Collector Credentialing Specialist will play a pivotal part… more
- Bristol Myers Squibb (Brisbane, CA)
- …Team (CDT) * Study-Leader with ability to own/drive study level strategic decisions * Leads medical data review of trial data, including eligibility review * ... Cell Therapy** The Clinical Trial Physician, Rheumatology, is the primary source of medical accountability and oversight for one or more clinical trials within the… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …consistency and alignment of messaging across channels. + Serve as a champion and lead Medical Review / Promotional review processes for materials + Manage ... Scientific Communications manages the execution of the core scientific and medical communications strategy for the relevant therapeutic area portfolio. This role… more
- Sedgwick (Sacramento, CA)
- …and providers to support the claim request and documents decision rationale. + Completes medical review of all claims by reviewing medical documentation ... PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, and/or complexity.… more
- Sharp HealthCare (San Diego, CA)
- …from provider and communicates this to the care team.Refer defined cases for medical secondary review and share findings with providers.Provide advice to Revenue ... requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the… more
- Parexel (Sacramento, CA)
- …role.** We're currently seeking a highly experienced Clinical Regulatory Leader, Health Authority Medical Review Team Lead, Master/Senior Medical Review ... with a regulatory agency (such as the FDA or MHRA) as a Senior / Master Medical Review Officer, Team Lead, etc. or a related medical role is required. _Depth… more
- Sharp HealthCare (La Mesa, CA)
- …from provider and communicates this to the care team.Refer defined cases for medical secondary review and share findings with providers.Provide advice to Revenue ... requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the… more