• Medicare Advantage Risk Adjustment Business…

    UCLA Health (Los Angeles, CA)
    Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... both internal and external reporting. You will: + Ensure data quality and accuracy through rigorous assurance checks. + Develop and maintain reports, from ad hoc… more
    UCLA Health (06/11/25)
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  • Senior Quality Analyst , Claims…

    Providence (CA)
    …Senior Quality Analyst assists the Claims leaders in managing a quality assurance program to ensure compliance with laws and regulations pertaining to ... Analyst is also responsible for maintaining a claims quality assurance program, management of projects and...aides and technical support for caregivers regarding Centers for Medicare and Medicaid Services (CMS) Medicare Secondary… more
    Providence (08/01/25)
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  • Clinical Data Analyst III (HEDIS, Tableau,…

    LA Care Health Plan (Los Angeles, CA)
    …care measures such as those used by National Committee for Quality Assurance (NCQA), HEDIS, Centers for Medicare and Medicaid Services (CMS), and State. ... are used for internal and external reporting, the tasks including data quality assurance , process programming, specification documentation and report developing.… more
    LA Care Health Plan (07/06/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Sacramento, CA)
    …Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance , and compliance + Determining root causes driving issues ... put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
    Humana (07/29/25)
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  • Customer Solution Center Audit Readiness…

    LA Care Health Plan (Los Angeles, CA)
    …Solution Center Business Analyst to track, trend, and analyze results of Quality Assurance (QA) scorecards for training and quality improvement. Perform ... Medicare and Medicaid Services(CMS), LACC - CalHers, and National Committee for Quality Assurance (NCQA) along with review and analysis of regulatory… more
    LA Care Health Plan (07/17/25)
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  • Supervising Physician Specialist - All Specialties…

    City and County of San Francisco (San Francisco, CA)
    …experience + Engaging staff and improving their experience + Participating in quality assurance activities Once submitted, applicant responses on the Required ... reapply. The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in… more
    City and County of San Francisco (07/07/25)
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  • Senior Physician Specialist - All Specialties

    City and County of San Francisco (San Francisco, CA)
    …methods, and procedures within the specialty area; including but not limited to Quality Assurance activities; prepares or reviews detailed and complex medical ... reapply. The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in… more
    City and County of San Francisco (05/21/25)
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  • Facility Coding Inpatient Complex Coder

    Banner Health (CA)
    …patient treatment information or documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for ... accurate code assignment. 3. Provides coding quality assurance for medical records. For all...prior to referral to senior manager, educator or Coding Quality Analyst . MINIMUM QUALIFICATIONS High school diploma/GED… more
    Banner Health (07/10/25)
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  • Health Facilities Program Manager, Nursing

    The County of Los Angeles (Los Angeles, CA)
    …to a staff of consultants; manage informal dispute resolution, compliance, and quality assessment and assurance monitoring processes; and handle informal ... consultative and enforcement services in the evaluation of total patient quality -of-care provided by hospitals and other health care facilities in accordance… more
    The County of Los Angeles (06/05/25)
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