- UCLA Health (Los Angeles, CA)
- …specialty pharmacy, required + Proven background in pharmacy clinical operations, including prior authorization , appeals, grievances + Experience with EPIC EHR ... functionality + Proficient in Microsoft Word and Excel + Strong commitment to patient confidentiality and thorough knowledge of HIPAA requirements, required UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity,… more
- Cedars-Sinai (Los Angeles, CA)
- …and holidays, ensures outside lab kits are available, refills medications and submits for prior authorization if needed. Acts as the super trainer for Point of ... Care urine and glucometer and performs NST testing in the Prenatal Diagnostic Center when coverage is needed. **Qualifications** **Qualifications:** Education: + GED or Highschool Diploma **License/Certifications:** + Current, unrestricted California LVN… more
- UCLA Health (Los Angeles, CA)
- …in scheduling tests and surgeries. + Experience working with various insurances, and prior authorization process. + Ability to work efficiently and calmly under ... occasional high-pressure situations or deadlines. + Excellent interpersonal and communication skills to deal with patients, physicians, medical professionals, and co-workers. + Skill in working independently with accuracy and ability to follow instructions… more
- Centene Corporation (Sacramento, CA)
- …(BH) and/or autism spectrum disorder needs and clinical standards + Performs prior authorization reviews related to BH to determine medical appropriateness ... in accordance with ABA regulatory guidelines and criteria + Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers as appropriate to discuss level of care and/or services provided to members… more
- Cardinal Health (Sacramento, CA)
- …cycle management specialists simplify and optimize the practice's revenue cycle, from prior authorization through billing and collections. **Job Purpose:** This ... position is responsible for the management and maintenance of the revenue cycle practice management system, including the accurate loading and mapping of fee schedules, effective CPT code management, the upkeep of the ICD-10 diagnosis directory, and insurance… more
- CVS Health (Sacramento, CA)
- …for clinical and legal review. + Provide day-to-day support and guidance for ABA prior authorization clinical team and the health plan medical directors. + ... Attend and participate in clinical meetings with care management and utilization management. Provide subject matter expertise on all ABA-related questions and member issues. + Support provider education initiatives for providers with a neurodiverse specialty… more
- The County of Los Angeles (Los Angeles, CA)
- …criteria set forth by pharmacy services chief. + Submits or troubleshoots prescription prior authorization requests as directed by a licensed pharmacist. + ... Corresponds with pharmacy staff at dispensing pharmacies, patients and prescribers in regards to prescription status. + Assists a licensed pharmacist to process prescription refill requests and obtains prescription fill histories. + Replenishes the drugs in… more
- Cardinal Health (Sacramento, CA)
- …cycle management specialists simplify and optimize the practice's revenue cycle, from prior authorization through billing and collections. The **Revenue Cycle ... Management (RCM) Integrations Manager** plays a critical role in ensuring the smooth onboarding and operational integration of new oncology clinical practices into the MSO's centralized revenue cycle framework. This role is responsible for managing all phases… more
- Evolent (Sacramento, CA)
- …Managers to ensure successful adoption and engagement of Evolent's solutions (ie, prior authorization , clinical pathways) to ensure timely patient access to ... care and drive high provider satisfaction, measured by CSAT and NPS scores + Support the development and execution of innovative engagement opportunities such as regional clinical symposiums and local provider experience advisory panels + Own market level… more
- Stanford Health Care (Palo Alto, CA)
- …access for patients -Precepting of residents/students -Projects and assignments as assigned - Prior Authorization Consultation Service **This is a Stanford Health ... Care job.** **A Brief Overview** Provides the full range of distributive, clinical, consultative, research, investigational, and/or administrative pharmaceutical services. Incumbents select, compound, manufacture, purchase, dispense, and/or preserve drugs,… more
Recent Searches
- Sr Network System Engineer (United States)
- Cx Program Manager (United States)
- Library Page Performing (United States)
- Process Engineer Materials Science (United States)
Recent Jobs
-
Academic Wage - Hourly: 2025 R/V Elakha Relief Master Pool
- Oregon State University (Newport, OR)
-
Wafer Manufacturing Chemical Support Operator (Night Shift)
- Western Digital (San Jose, CA)
-
Help Desk Technician / Help Desk Specialist
- EPS Corporation (Randolph Air Force Base, TX)
-
Controls Assistant Manager
- LEGOLAND (Winter Haven, FL)