• Clinical Quality and Risk Liaison LVN

    Dignity Health (Bakersfield, CA)
    …practice staff in clinical quality measures, medical record documentation, and risk coding guidelines. - Collects, summarizes and trends provider performance data to ... provider, clinic staff, member, and/or health plan encounters. - Partners with physicians/ physician staff to find ways to explore new ways to encourage member… more
    Dignity Health (08/01/25)
    - Related Jobs
  • Dialysis Clinical Manager Registered Nurse - RN

    Fresenius Medical Center (Moreno Valley, CA)
    …the Annual Standing Order Review and Internal Classification of Disease (ICD) coding . + Manages clinic financials including efficient utilization of supplies or ... scheduling and payroll. PHYSICIANS: + Facilitates the application process for physician privileges and compliance with Fresenius Medical Care Medical Staff By-Laws.… more
    Fresenius Medical Center (07/23/25)
    - Related Jobs
  • UM LVN

    Dignity Health (Bakersfield, CA)
    …to review medical records, authorize requested services and prepare cases for physician review based on medical necessity. The position partners with both the ... to apply or modify as appropriate. - Knowledge of ICD-10, CPT, HCPCS coding , medical terminology and insurance benefits. - Knowledge of legal and ethical… more
    Dignity Health (07/13/25)
    - Related Jobs
  • Gastroenterologist

    Dignity Health (Woodland, CA)
    …medical findings, diagnoses, and treatment plans. + Ensure compliance with coding and billing regulations. **Diagnostic Procedures:** + Order and interpret ... a growing multispecialty group, is seeking to add a BE/BC Gastroenterology Physician . Candidates with ERCP preferred, but not required. **Opportunity Highlights:** +… more
    Dignity Health (07/12/25)
    - Related Jobs
  • Senior Pharmacist

    Highmark Health (Sacramento, CA)
    …and stakeholders. Secondary responsibilities will also include supporting formulary coding , implementation, and testing processes in partnership with the pharmacy ... and development, member facing outreach initiatives + Develop and implement physician , pharmacy, account, and member educational initiatives that promote the… more
    Highmark Health (06/26/25)
    - Related Jobs
  • Patient Care Coordinator II

    Stanford Health Care (Atherton, CA)
    …assisting program(2) Completion of medical assistant training by a licensed physician or podiatrist(3) Certification as medical assistant through a Medical Board ... to use and apply medical terminology in performing his/her duties.* Knowledge of coding and billing regulations.* Knowledge of computer systems and software used in… more
    Stanford Health Care (08/12/25)
    - Related Jobs
  • Case Manager II, Registered Nurse

    Sutter Health (Burlingame, CA)
    …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager, Medical Social Worker and bedside RN to assure the ... levels of care and associated regulatory compliance requirements. General understanding of coding and DRG assignment process preferred. Must be able to effectively… more
    Sutter Health (08/10/25)
    - Related Jobs
  • Case Manager

    Cardinal Health (Sacramento, CA)
    …providing an empathetic and supportive experience to the patients, providers, and physician offices * Resolve patient's questions and concerns regarding status of ... prior authorization and appeals experience highly desired * Knowledge of ICD coding , preferred * Intermediate Microsoft skills with specific experience with Excel *… more
    Cardinal Health (08/09/25)
    - Related Jobs
  • Medical Director - Mid West Region

    Humana (Sacramento, CA)
    …require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient ... scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities,… more
    Humana (08/08/25)
    - Related Jobs
  • Claim Adjuster - Liability

    Sedgwick (Sacramento, CA)
    …claimant and client. + Ensures claim files are properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical ... claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. + Maintains professional client… more
    Sedgwick (08/08/25)
    - Related Jobs