- Stanford Health Care (Palo Alto, CA)
- …management experience. + Experience in concurrent review, discharge planning and transition management . + Working knowledge of CMS and NCQA requirements for ... skilled nursing facility concurrent review and complex and episodic case management , including the care plan development and ongoing intervention strategies. This… more
- UCLA Health (Los Angeles, CA)
- …years of experience in healthcare reimbursement, financial analysis, or revenue cycle management (required) + In-depth understanding of Medicare and Medi-Cal ... that directly support the financial sustainability of the hospital system . Reporting to the Director of Reimbursement, this role...this role, you will: + Prepare and file annual Medicare and Medi-Cal cost reports and lead audit responses… more
- Stanford Health Care (Palo Alto, CA)
- …**Locations** Stanford Health Care **What you will do** + Responsibility for management and optimization of the positive relationships between CDI and the service ... documentation integrity programs, including related provider and multidisciplinary education content creation, delivery and evaluation of effectiveness. + Leads… more
- Highmark Health (Sacramento, CA)
- …leadership, problem-solving, data analytics, team development, communication, implementation, and project management . The incumbent often plays a central role in the ... include elements of team leadership, problem-solving, data analysis, project management , communication, implementation, and provider and/or provider-facing team education… more
- Stanford Health Care (Palo Alto, CA)
- …revenue cycle management . + Ten (10) years leading middle/upper-level management . + Recent EPIC system sue/experience including financial (billing - ... responsible for providing strategic leadership and direction for the health system 's mid-revenue cycle operations across the enterprise. This role involves… more
- Sharp HealthCare (San Diego, CA)
- …standard and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid ( CMS ), and AHIMA for assignment of diagnostic and ... Registered Health Information Administrator (RHIA) - The American Health Information Management Association (AHIMA); Certified Coding Specialist (CCS) - The American… more
- Prime Healthcare (Ontario, CA)
- …California Applicants: https://www.primehealthcare.com/wp- content /uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect ... Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates...This role is pivotal in ensuring adherence to the CMS Price Transparency Rule and other federal and state… more
- Humana (Sacramento, CA)
- …or CMS guidelines, assessment and documentation practice + Case Management certification (CCM) + Bilingual in English and Spanish **Work-At-Home Requirements** ... Our nurses are titled Care Managers, because our case management services are centered on the person rather than...of the business day, primarily through an auto dialer system . Environment is fast paced and requires ability to… more
- Highmark Health (Sacramento, CA)
- …drug benefit strategies, drug formularies, and programs specifically for the Medicare Advantage (MA) market. The incumbent will contribute to recommendations for ... Committee review. + Assist in the development and implementation of utilization management programs including but not limited to: prior authorization, dose and… more
- LA Care Health Plan (Los Angeles, CA)
- …Health Care Services (DHCS), Department of Public Social Services (DPSS), Centers for Medicare and Medicaid Services( CMS ), LACC - CalHers, and National Committee ... regulatory audits. This position will develop, with the assistance of CSC management , a successful auditing strategy for the following end-to-end processes within… more