- RGP (Los Angeles, CA)
- …work independently and manage multiple priorities. + Must be out of Healthcare Payer side of the business. + Proficiency in Microsoft Office tools (Excel, ... PowerPoint, SharePoint). + Must have one of these certifications: CPA, CIA, CMA, or CFE. + Flexible transportation for local travel to off-site meetings or audits. + Variety of workplace arrangements including hybrid, remote, onsite. + Compensation… more
- Cardinal Health (Sacramento, CA)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas,… more
- Sharp HealthCare (San Diego, CA)
- …per departmental process.Conduct daily concurrent reviews per protocol/policy and payer request.Utilize appropriate care guideline software to identify the correct ... patient status and level of care.Work with attending provider to assure correct status, if status and order does not match; works with provider to resolve conflict and document interventions in the EMR.Assure correct documentation is present for 2MN benchmark… more
- CommonSpirit Health (Rancho Cordova, CA)
- …CNOs, CFOs, CMOs, CNOs, and departments such as Revenue Cycle, Payer Strategy, Community Health, Physician Enterprise Continuing Care, Quality, Performance ... Improvement, Ethics, and Legal. Serves as a proactive advisor, utilizing data analytics to align goals and enhance operational, clinical, quality, and patient experience outcomes. + **Strategic Development and Implementation** : Implements robust strategies… more
- Sharp HealthCare (San Diego, CA)
- …procedures for confidentiality and HIPAA guidelines. Documentation meets all third-party payer (Medicare, PPO, Work Comp and HMO) and regulatory requirements. ... Completes all notes and billing daily. Completes all tasks and documentation needs (ie utilization management, plan of care, medical necessity reviews) based on department and regulatory requirements. + Professional and Departmental Development Identifies… more
- Lundbeck (San Diego, CA)
- …position Lundbeck's products within the context of the provider's setting and payer mix. Managing Execution + Sets and maintains competent product knowledge and ... selling skills standards within the team. Directs and monitors the execution of approved marketing plans and promotion campaigns. Evaluate and identify improvement and development opportunities of account managers through performance management process to… more
- Bristol Myers Squibb (San Jose, CA)
- …Maintains expertise in changing healthcare landscape, including market trends and payer dynamics. + Proactively shares reimbursement related education to offices as ... appropriate, educating staff on enrolling appropriate patients into BMS patient support programs. + Reactively manages patient cases enrolled into BMS Hubs, working with office staff to facilitate continuity of care, post the clinical decision. + Compliantly… more
- LA Care Health Plan (Los Angeles, CA)
- …2 years of experience working as a Project Manager. Preferred: Prior healthcare insurance payer experience. Minimum of 7 years of experience working in a mixed AGILE ... and traditional IT environment. Experience working with SQL Server and ORACLE databases. Experience leading teams in the development of services software. Skills Required: Excellent written and verbal communications skills. Demonstrated strong leadership… more
- UCLA Health (Los Angeles, CA)
- …on capital campaign finances, ensures effective billing systems, and leads complex payer rate increase efforts and related audits. _The University of California, Los ... Angeles is required to provide a reasonable estimate of the compensation range for this role. This range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to experience, skills,… more
- Sutter Health (Vallejo, CA)
- …systems, telephone consoles, document imaging, scanning, payment posting, proprietary payer websites and data quality monitoring, both accurately and efficiently ... Strong data entry skills required Excellent verbal and written communication and active listening skills Interpersonal skills necessary in dealing with internal and external customers Must possess a personal presence that is characterized by a sense of… more