- Genesis Healthcare (Elk Grove, CA)
- …of Rehab with conducting or coordinating the timely completion of the annual merit review for therapy staff. 6. Assists in management of therapy staff. 7. Assists in ... daily staffing and utilization in cooperation with input from treating therapists, consideration...of the highest standard of rehabilitation services through appropriate utilization of resources, the promotion of clinical programs, and… more
- Highmark Health (Sacramento, CA)
- …of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member ... Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a ...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- Sharp HealthCare (La Mesa, CA)
- …required within 90 days of hire. **Essential Functions** + Verification and review of medication ordersReviews all medication orders for appropriate dose, duration, ... protocols and consultation with the interdisciplinary team.-Completion of a daily profile review for each patient consisting of the following elements:* Age, sex,… more
- The County of Los Angeles (Los Angeles, CA)
- …solicitations and contracts are developed pursuant to best practices. Review contracting opportunities with applicability to Community-Based Organizations (CBOs), ... and advertisements are provided and facilitate opportunities for competition. Review Department solicitation practices to provide strategic recommendations and… more
- Humana (Sacramento, CA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Humana (Sacramento, CA)
- …Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical management review organization ... us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments… more
- Naval Medical Command (Camp Pendleton, CA)
- …will review , evaluate and make recommendations consistent with manpower utilization and position management objectives on requests to establish new positions, ... used to gather, analyze and evaluate information concerning Manpower utilization and Human Resources Management Processes. Experience utilizing analytical and… more
- Highmark Health (Sacramento, CA)
- …both internally developed and vendor-sourced criteria. This includes proactive monitoring, review , and timely updates in response to new evidence, regulatory ... data-driven insights from complex healthcare datasets (eg, claims, clinical, utilization , pharmaceutical) to inform policy development, identify areas for… more
- Three Saints Bay (Port Hueneme, CA)
- …functions + Two (2) years of experience directly related with utilization of Content Management Systems, learning Management Systems, and/or Sharable Content ... (R&M) Modeling, Prediction, Allocation and Analysis for program evaluations, review , or implementation. **Desired Qualifications:** + Demonstrated experience analyzing… more
- WSP USA (San Bernardino, CA)
- …in accordance with all acceptable engineering practices. + Perform engineering review of permit applications, engineering design plans and specifications, standby ... technical excellence through direct project delivery demonstrated by set performance utilization goal as Technical Excellence Practices Leader. + Key performance… more