- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + ... and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES...documented on all patient medical records. 6. Coordinates with Care Management team when cases do not… more
- Stanford Health Care (Palo Alto, CA)
- … job.** **A Brief Overview** This role ensures the provision of quality patient care by ensuring the clinical competence of Case Managers, Social Workers, ... and case management and delivery of interventions. **Locations** Stanford Health Care (Palo Alto, CA; onsite) **What you will do** + Promotes individual… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- …issues, claims reviews, grievances, appeals , and other medical management challenges. Directs and supervises assigned clinical projects. Administrative ... duties and administrative responsibilities. This position involves providing direct patient care , supporting medical providers, and spearheading key clinical … more
- Elevance Health (Palo Alto, CA)
- …is a benefit- management leader in Illinois. Our platform delivers significant cost-of- care savings across an expanding set of clinical domains, including ... ** Clinical Operations Medical Director** **Utilization Management ...initial nurse review, of Medical Oncology regimens and supportive care . + Perform physician-level case review, following initial nurse… more
- Elevance Health (Palo Alto, CA)
- …is a benefit- management leader in Illinois. Our platform delivers significant cost-of- care savings across an expanding set of clinical domains, including ... Operations determine the medical necessity of outpatient radiology, cardiology and sleep management requests using clinical guidelines and health plan medical… more