- Cedars-Sinai (Beverly Hills, CA)
- …**Job Duties and Responsibilities:** + Greets patients, take appropriate vital signs, review current medications and record in medical record + Coordinates, ... **Job Description** **Join Cedars-Sinai!** **Cedars-Sinai Medical Center has been ranked the #1 hospital in California and #2 hospital in the nation by US** **News**… more
- Ventura County (Ventura, CA)
- …in-services and staff development programs; + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments; ... Medical Surgical and Telemetry Registered Nurse II -...Pool -Regular and Per Diem Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4935075) Apply Medical Surgical and Telemetry Registered Nurse II - Float… more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team ... and communication skills and the ability to interact with Medical Directors, Providers, CSMNS members, Medical Group...Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as needed. + Assists… more
- Cedars-Sinai (Beverly Hills, CA)
- …You Will be Doing** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team ... 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded...Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as necessary. + Assists… more
- Cognizant (Sacramento, CA)
- …+ Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. + Excellent problem-solving skill in ... with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or...UB or HCFA paper or EDI information. + Evaluate medical records to determine if the service rendered was… more
- Dignity Health (Bakersfield, CA)
- …of defined levels of hierarchy and composition of compliant denial notices to review medical records, authorize requested services and prepare cases for ... physician review based on medical necessity. The position...to coordinate patient care. - Promotes quality, cost effective medical care through strict adherence to all utilization… more
- The County of Los Angeles (Los Angeles, CA)
- …prevention services including but not limited to forecasting utilization and cost, cost/finance analyses, cost-effectiveness analyses, and predictive/prescriptive ... revenue, and to reduce the cost of unnecessary waste and over/under utilization of services. + Conducts predictive data assignments for Behavioral Health Quality… more
- Robert Half Office Team (Los Angeles, CA)
- Description REMOTE TEMP POSITION- MSA Coordinator- 90 Day Assignment Position: Medical & Scientific Affairs (MSA) Coordinator Location: 100% Remote - 8:00 AM-5:00 PM ... and hiring now Position Description We are seeking a detail-oriented, highly organized Medical & Scientific Affairs (MSA) Coordinator to support our US Medical … more
- CVS Health (Sacramento, CA)
- …Under the direction of the Lead Clinical Psychologist, this position will focus on utilization , quality, and review of fraud, waste, and abuse for individual ... Aetna member cases. **Expectations/Responsibilities:** + Review and prepare cases for ...based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols. + Serve… more
- Fresenius Medical Center (San Bernardino, CA)
- …Manager to oversee the facility's Home Therapies Program. * Maintains integrity of medical and operations records and complies with all data collections and auditing ... activities. *Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. *Manages clinic financials including… more