- Citigroup (Glendale, CA)
- …work closely with their assigned Financial Advisors to conceptualize, propose, and review tailored investment portfolios for Citi Global Wealth's high net worth ... the Citi Global Wealth platform to determine performance levels, and periodically review and update product parameters and policies to ensure profitability and… more
- Humana (Sacramento, CA)
- …key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus on our 5+ million ... Responsibilities** **:** + Lead an operational team of Medical Directors to review authorizations and ensure clinical decision-making skills that align to internal… more
- JPMorgan Chase (Long Beach, CA)
- …knowledge and solutions + Experience adhering to policies, procedures, and regulatory banking requirements **Federal Deposit Insurance Act** This position is subject ... such, an employment offer for this position is contingent on JPMorganChase's review of criminal conviction history, including pretrial diversions or program entries.… more
- Banc of California (Goleta, CA)
- …expanding existing relationships and ensuring compliance with overall Bank and regulatory policies and guidelines. To accomplish this, the Branch Manager builds ... person meetings. Regularly meets with internal business partners to communicate and review business results and pipeline management. + Treat people with respect;… more
- Evolent (Sacramento, CA)
- …within the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …from Explanation of Benefits (EOB) and Remittance Advice (RA). As well, they are to review CCI or payor specific coding edits and take necessary steps to send a ... they will forward claim on to leadership for further review and or appropriate resolution of claim. Incumbent is...Incumbent is expected to follow federal, state, and local regulatory collection guidelines as well as department and payor… more
- Evolent (Sacramento, CA)
- …calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provides clinical rationale for standard ... and expedited appeals. . Utilizes medical/clinical review guidelines and parameters to assure consistency in the...guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with… more
- Banc of California (Glendora, CA)
- …duties of the branch staff to ensure audit compliance and new account review requirements. + Oversees daily check scanning, vault settlement, and ATM settlement, ... and Branch Administration regarding responses for independent third party and regulatory audits; ensures deficiencies identified from such audits are corrected. +… more
- Evolent (Sacramento, CA)
- …calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request. + Provides clinical rationale for standard ... and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the...guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with… more
- Datavant (Sacramento, CA)
- …Track and report on coding productivity and quality metrics for leadership review . + Maintain coding policies, procedures, and workflow documentation. + Implement ... process improvements to enhance accuracy, efficiency, and regulatory compliance. + Ensure coding is completed within established turnaround times to support timely… more