- 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
- Highland General Hospital (Oakland, CA)
- …Responsible for the recruitment, orientation, evaluation, counseling and disciplinary action of care management clinical and administrative staff. + ... Performs daily clinical rounds and monthly audit of charts on care management activities (utilization review, discharge planning and Interrater Reliability).… more
- Highland General Hospital (Oakland, CA)
- …for the recruitment, orientation, evaluation, counseling and disciplinary action of care management clinical and administrative staff. -Responsible ... daily clinical rounds and monthly audit of charts on care management activities (utilization review, discharge planning and Interrater Reliability).… more
- City and County of San Francisco (San Francisco, CA)
- …Health SF, and California Advancing and Innovating Medi-Cal (CalAIM) and their impacts on clinical care + Collaborates with the Director of Managed Care ... Care division which oversees the Office of Coordinated Care (OCC), Utilization Management (UM), and Quality...after 10/1/2023 The role will be 10-30% dedicated to clinical responsibilities with the remaining 70-90% dedicated to Deputy… more
- Elevance Health (San Francisco, CA)
- **RVP II Sr Clinical Officer (Commercial)- California** **Location:** **California** **Summary** In this role as the RVP II Sr Clinical Officer for one of our ... business segment. In this role your focus will be clinical expertise, strategic, and cross-functional leadership to drive strategic...determine and improve factors contributing to variations in health care cost and quality while managing a team in… 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
- City and County of San Francisco (San Francisco, CA)
- …their lifecycles. We lead with equity to support our membership in accessing the care they need when they need it, regardless of personal characteristics such as ... and socioeconomic status. We also strive to engage members in personalized care that centers disease prevention and equitable services for optimal health. Learn… more
- Elevance Health (Walnut Creek, CA)
- …projects and initiatives **Required Qualifications:** + Requires minimum of 3 years acute care clinical experience or case management , utilization ... care and accurate claims payment. May also manage appeals for services denied. **How You Will Make an...territory of the United States. **Preferred Qualifications:** + Acute care clinical experience is a must +… more
- City and County of San Francisco (San Francisco, CA)
- …training and proper use of the new system. + Participates in direct patient care / clinical activities as part of Dental Services. The Director of Dental Services ... Health Network is the City's only complete system of care and has locations throughout the City, including Zuckerberg...Dental Services. + Ensures that evaluation and treatment of clinical services provided to dental patients are in compliance… more
- City and County of San Francisco (San Francisco, CA)
- …nutritional and employment support to child and adult protective services, health care coverage, affordable childcare, and in-home services for older adults and ... of Aging and Adult Services provide a broad range of clinical /advocacy services to temporary/permanent conservatees and collateral contact with a multidisciplinary… more
- Sutter Health (Berkeley, CA)
- …visitors and each other with courtesy, dignity, respect and professionalism. RELATIONSHIP MANAGEMENT : * Assists physicians and patients with appeals process when ... effective, and cost efficient medication therapy. Exercises sound judgment, and developed clinical skills to provide pharmaceutical support to the patient's plan of … 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
- City and County of San Francisco (San Francisco, CA)
- …nutritional and employment support to child and adult protective services, health care coverage, affordable childcare, and in-home services for older adults and ... self-neglect, and financial abuse. The PSW performs professional investigations and case management services to victims of abuse. This includes activities related to… more
- City and County of San Francisco (San Francisco, CA)
- …the profession, familiarity with psychopharmacology, co-occurring disorders, principles of clinical case management , effective assessment, advocacy, community ... relationships by collaborating with other service providers (eg nurses, primary care providers with probation and child welfare, psychologists, teachers, lawyers,… more
- City and County of San Francisco (San Francisco, CA)
- …process; and prepares written care summaries for the purpose of coordinating care ; + Performs clinical evaluations in the more difficult individual cases by ... standards of the profession, familiarity with psychopharmacology, principles of clinical case management , effective assessment, advocacy, community organization,… more
- Elevance Health (Walnut Creek, CA)
- … clinical consultation and serve as clinical /strategic advisor to enhance clinical operations. May identify cost of care opportunities. May serve as a ... in healthcare. + Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality cost and outcomes. Identifies… more
- City and County of San Francisco (San Francisco, CA)
- …From financial, nutritional and employment support to protective services, health care coverage, affordable childcare, and in-home services for older adults and ... Under general supervision, Protective Service Workers perform professional investigation, case management , and casework services at the, Family & Children's Services… more
- Elevance Health (Walnut Creek, 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 (Walnut Creek, CA)
- ** Clinical Operations Associate Medical Director** **General Orthopedic Surgery** Full Time **_Sign on Bonus: $7,500_** **Location:** This position will work a ... locations with a preference for California. The **Orthopedic Surgery Clinical Operations Associate Medical Director** is responsible for performing… more
- City and County of San Francisco (San Francisco, CA)
- …The San Francisco Health Network is the City's only complete system of care and has locations throughout the City, including Zuckerberg San Francisco General ... Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. The Department of Public Health prioritizes equitable and inclusive… more