- 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 ... or absence of clinical information related to the criteria applied. - Evaluates out-of- network and tertiary denials for accessibility within the network . -… more
- Sharp HealthCare (San Diego, CA)
- …bargaining agreement between Sharp HealthCare and Sharp Professional Nurses Network , United Nurses Associations of California/Union of Health Care Professionals, ... Healthcare Professional (AHA BLS Healthcare) - American Heart Association ** Preferred Qualifications** + **Ophthalmology experience preferred .** **Essential… more
- Cardinal Health (Sacramento, CA)
- …+ Manage workload of inbound faxes (if applicable) + Investigate and resolve patient/ physician inquiries and concerns in a timely manner + Have the ability to ... confirmations or to obtain missing information + Mail out appropriate documents to physician offices + Interact with the patient referral sources to process new… more
- Alameda Health System (Oakland, CA)
- …Case Management functions. + Works closely with the VP of Care Management and Physician Advisors on any audits and secondary reviews; may include but not limited to ... the inpatient recovery process; works closely with Revenue Cycle and AHS Physician Advisors; regularly communicates with payors and/or their contracted vendors. +… more
- Dignity Health (Bakersfield, CA)
- …School of Medicine, our focus on GME expansion is to: *Diversify the physician workforce and address the national physician shortage; *Concentrate training ... accredited school. + A current and valid license as physician and surgeon (LIC OSTPHY - Osteopathic Phys-Surgeon) in...OSTPHY - Osteopathic Phys-Surgeon) in the state of California. Preferred Qualifications: + Minimum five (5) years of experience… more
- Elevance Health (Los Angeles, CA)
- …and quality teams and participates in helping to address concerns. + Conducts quarterly physician record reviews or as needed with network providers across all ... company HEDIS performance. Implements strategies that meet clinical, quality, and network improvement goals. + Build positive working relationships with providers,… more
- Cedars-Sinai (Beverly Hills, CA)
- …functions as an administrative team lead for the office. This position supports the physician and nursing staff in the delivery of health care by performing a broad ... satisfactory resolution. + Assists with administrative support activities to address physician and staff concerns such as facilities management, patient billing,… more
- Deloitte (Monterey, CA)
- …for Self-insured Health plans administrators and PBMs + Experience performing hospital / physician network discount and network disruption analyses + ... include working with payers and providers in such projects as provider network development, operational claim reviews, etc. The team Deloitte's Government and Public… more
- Cedars-Sinai (Beverly Hills, CA)
- …California! We would be happy to hear from you. The Cedars-Sinai Medical Network is committed to helping primary care and specialist physicians provide excellent ... we have been named one of the top 20 Physician Groups in Southern California by Integrated Healthcare Associates...1+ years of LVN experience in an outpatient setting preferred \#Jobs-Indeed \#LI **Req ID** : 7900 **Working Title**… more
- The County of Los Angeles (Los Angeles, CA)
- …juvenile justice system and inmates in the LA County jails. Across the network of DHS' directly operated clinical sites and through partnerships with community-based ... nuclear medicine. Essential Job Functions Consults with and assists the physician in determining proper level of treatment; such determinations include establishing… more