- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization, ... provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present educational… more
- Sharp HealthCare (San Diego, CA)
- …when not in use.Is knowledgeable of current laws and regulations regarding Utilization Review and Discharge Planning.Morning arrival time insures orderly ... + Data collectionParticipates in data and statistics collection as requested by Utilization Review , Service Line and Quality Improvement Committees. + Denial… more
- Dignity Health (Bakersfield, CA)
- **Responsibilities** This position is remote , but will be expected to work PST business hours.** **Position Summary:** The Manager, Network Strategy and Contracting ... to senior leadership. - Analyzes network performance, including cost, quality, and utilization data to identify trends, opportunities, and areas for improvement. -… more
- GitHub (CA)
- …teams to write faster, better code. **Locations** In this role you can work from Remote , California United States | Remote , Washington United States | Remote ... , Oregon United States | Remote , Arizona United States | Remote , United States **Overview** GitHub is growing its Customer Success & Support team and we're… more
- Humana (Sacramento, CA)
- …initiatives. + Collaborate with various operational functions in the centralized utilization management team and other shared services. + Participate in quality ... governance, peer review , and grievance resolution processes. Innovation & Transformation: +...pilot and scale emerging technologies and care models (eg, remote monitoring, clinical pathways, tech-enabled care). + Lead regional… more
- Coinbase (Sacramento, CA)
- …you, there's no better place to be. While many roles at Coinbase are remote -first, we are not remote -only. In-person participation is required throughout the ... analysis, risk assessments, development of the audit plan, project management, quality review , report issuance and issue validation across IT and business functions.… more
- Highmark Health (Sacramento, CA)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... and servicing quality dental networks in assigned territory in a remote and mobile work environment. Manage network contracts including negotiations, contract… more
- Teleflex (Los Angeles, CA)
- …meetings is an ongoing responsibility and administrative duties include expense report review to assure compliance with company policies and regular utilization ... Coach team members to predict monthly/quarterly/yearly forecast within 5% +/-. Review sales representatives expense reports to assure compliance with company… more
- Battelle Memorial Institute (San Diego, CA)
- …and destruction. We are looking for a leader to provide scoping, review and oversight for cleaning and replacement projects associated with transition needs. ... This position offers the flexibility of ** remote work** . Candidates based near Columbus, OH, can...engineering contractors, including the development of SOWs and RFPs, review of contractor submittals, and coordination of replacement activities… more
- Veterans Affairs, Veterans Health Administration (Ukiah, CA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... palpitation, auscultation, collecting vital signs. Incumbent performs retrospective medical review of non-VA health care records to determine medical necessity… more