- Centene Corporation (Sacramento, CA)
- …and if identified, refer to the Medical Director or provider for review and verification + Consults with senior management and healthcare providers, as ... California RN Licensing Highly Preferred **Position Purpose:** Performs a clinical retrospective review of services previously provided to determine if the level of… more
- CenterWell (San Diego, CA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- HCA Healthcare (Riverside, CA)
- …a data-driven environment of quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care in ... support for appeals and denials process, discharge planning, case management, and utilization review /management + You will consult with facility-level staff… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- …in a senior or executive medical leadership role (eg, Medical Director , Associate CMO, or CMO). + Demonstrated success in leading interdisciplinary teams and ... + Preventative and Chronic Disease Management. + Risk adjustment, cost, utilization , and value-based performance. + Access, including for those assigned but… more
- AECOM (San Francisco, CA)
- …in order to be able to identify support personnel and facilitate the quality review process for any regional project. In the event quality issues are identified, ... and implementation of solutions with the support of the Director of Project Delivery. + Ability to mentor junior...major pursuits by actively participating in the development and review of Project Plans and incorporation of other project… more
- Dignity Health (Bakersfield, CA)
- …**Position Summary:** The Manager, Network Strategy and Contracting reports to the Director of Provider Contracting. Key areas of oversight include negotiation of ... Identifies necessity for additional escalation and communicates issues effectively to senior leadership. - Analyzes network performance, including cost, quality, and… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- …Join Kite and help create more tomorrows. **Job Description** + The ** Senior Manager, Planisware Clinical Trial Planning, Resource Management, and Reporting** is a ... resident Planisware expert for the group. The position will report to the Director of Business Strategy & Operations. _Responsibilities include but are not limited… more
- Stanford Health Care (Menlo Park, CA)
- …goal of enhancing the delivery of patient care. FPD Planning is seeking a Senior Program Manager who brings a balance of leadership, technical expertise, and a deep ... FPD leadership + Develop test fits and create well thought-out options for review with stakeholders **Must have skills:** + Working knowledge of Bluebeam and… more
- CBRE (Sacramento, CA)
- …this position is to lead a large portfolio or client account and provide senior technical and operational support to the account staff for the development of ... Effectively recommends same for direct reports to next level management for review and approval. Monitors appropriate staffing levels and reports on utilization… more
- Sharp HealthCare (San Diego, CA)
- …input for performance appraisals and corrective action of assigned staff to Senior Specialists or Lab Manager/ Director ; completes performance appraisals within ... include oversight of near patient testing; performs technical lead duties.Apprises Senior Specialists, Lab Managers or Pathologists of conditions or situations that… more