- Elevance Health (Los Angeles, CA)
- …The **Clinical Operations Medical Director** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions ... Perform physician-level case review , following initial nurse review , of Medical Oncology regimens and supportive...necessity of requests using guidelines and client-specific health plan medical policy. + Conduct peer -to- peer … more
- Evolent (Sacramento, CA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... rationale for standard and expedited appeals. + Discusses determinations ( peer to peer phone calls) with requesting...(NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Sacramento, CA)
- …and provides clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. . Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. . Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Sacramento, CA)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Sacramento, CA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...expedited appeals. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Sacramento, CA)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- University of Southern California (Arcadia, CA)
- …and changes to licensed clinic personnel. + Serve as liaison between the medical staff and patients to answer questions, coordinate patient care, and/or ... As a Medical Assistant II, the incumbent will provide support...expected to provide some patient education. Daily interactions with staff , supervisor, and doctors, as well as periodic meetings… more
- Ventura County (Ventura, CA)
- …along with attendance to relevant meetings, including Agency physician leadership and medical staff meetings, and other meetings as requested. + Support ... limited to using two patient identifiers and time-out procedures. + Keeps all medical staff privileging requirements up to date, including CME requirements. +… more
- Fresenius Medical Center (Bellflower, CA)
- …+ Facilitates the application process for physician privileges and compliance with Fresenius Medical Care Medical Staff By-Laws. + Responsible for strong ... **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations.… more
- UCLA Health (Venice, CA)
- …management, compliance, and patient safety and is responsible for overseeing all peer review , credentialing, and privileging activities + Clinical care accounts ... people in need. The organization has more than 500 staff who serve 45,000 people with compassion, dignity, and...staff and the quality of care delivered by staff and volunteer medical clinicians. + Participates… more