- Merck & Co. (Los Angeles, CA)
- Job DescriptionAssociate Director , Field Access ManagementThe Associate Director , Field Access Management serves as the leader to a team of subject-matter ... management, or reimbursement support- Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) and related access processes, including… more
- Alameda Health System (Oakland, CA)
- …necessary and assists physicians with appeals. Maintains minimal denial rates by Medicare , MediCal , private and contracted payers through appropriate direction ... time off plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- Stanford Health Care (Palo Alto, CA)
- …America) **This is a Stanford Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within the Controller's Office, ... and regulatory reports to government agencies, including but not limited to: - Medicare and Medi-Cal cost reports -Financial disclosures to the Department of Health… more
- Emanate Health (Covina, CA)
- …STAR measures coding related functions. The coding specialist will work with the IPA Director , Health Plan, and MSO personnel on HCC and STAR measures related tasks. ... ensure the appropriate ICD10 and CPT codes submitted for Medicare and Covered CA lines of business. Coding specialist...of business. Coding specialist will be responsible to review medical records and claims data to ensure external physicians… more
- Stanford Health Care (Palo Alto, CA)
- …EMTALA, the Stark Law, Conflicts of Interest, Gifts and Entertainment, and Medicare and Medicaid program requirements. + Develop written policies, procedures, and ... duties and projects assigned by the Chief Compliance Officer and/or the Director of Compliance Program Management. **Education Qualifications** + Bachelors degree in… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …independent judgment. Communicates technical or general information to their manager, director , & medical staff. Participate in administrative activities. ... and microbiology in a CLIA-certified clinical laboratory by the Center for Medicare & Medicaid Services (CMS) **For Clinical Lab Scientist with Limited California… more
- CVS Health (Sacramento, CA)
- …of covered benefits in the Commercial and Medicare environment with a focus Medicare policy., This Medical Director provides subject matter expertise in ... day. **Position Summary** Aetna, a CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next level with a… more
- Humana (Sacramento, CA)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
