- Highmark Health (Harrisburg, PA)
- …not limited to: medical/surgical physician and institutional claims and encounters, clinical data, prescription drug data, membership data, dental and vision claims, ... benchmark data. + Lead the evaluation and selection of new complex clinical and technical products and methodologies necessary to enhance current capabilities and… more
- Signature Healthcare (Owensboro, KY)
- …a row and Modern Healthcare's "Best Places to Work!" Overview The ideal Signature Clinical Care Consultant Candidate would have working knowledge of Medicare, ... 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a...and standards of care are in place to achieve clinical , regulatory, and reimbursement compliance . + Provide… more
- CVS Health (Austin, TX)
- …care more personal, convenient and affordable. Position Summary The Quality Assurance Consultant fulfills the company purpose of helping people on their path to ... health by driving quality execution of PBM functional area performance. The Consultant will perform some monitoring activities. However, this position requires a… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The goal of the Clinical Documentation Specialist- Consultant is to educate leaders, physicians, advanced practice providers (APP), and other ... Coding Clinics, and other guiding references for coding accuracy and compliance . + Knowledge of clinical criteria, pathophysiology, evidence-based practice… more
- WellSense (Boston, MA)
- Provider Relations Consultant (Boston/Northeast MA) - $5000 sign on bonus! WellSense Health Plan is a nonprofit health insurance company serving members across ... Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide… more
- City of New York (New York, NY)
- …hire one (1) City Medical Specialist (Per Diem) to function as a Medical Consultant who will: - Indirectly supervise contracted clinical staff, share policies ... as Cash, Food and Rental Assistance as well as Medicaid . The Office of the Medical Director aims to...and decrease morbidity and mortality; and improve food safety, compliance with NYC Food Standards and the overall nutritional… more
- VHC Health (Arlington, VA)
- …the organization in four essential domains which include Patient Safety, Clinical Quality Management, Regulatory Compliance , and Performance Improvement. In ... Senior Quality Consultant Job Description Purpose & Scope: The Quality...These components along with knowledge and experience of frontline clinical operations will provide structure and oversight to improve… more
- CVS Health (Richmond, VA)
- …with clinical policy, regulatory and accreditation guidelines, and maximize compliance with Virginia Medicaid Waiver Programs. Implements corrective action ... the Central Region. Position SummaryResponsible for the review and evaluation of clinical information and documentation to determine if the plan is person-centered,… more
- UCLA Health (Los Angeles, CA)
- …recommendations, denial prevention strategies, improved patient experiences, and reduced compliance risks. You will: * Elevate leadership's understanding of current ... complex department-specific reporting packages * Translate patient access data and clinical application data to our professional fee billing systems to complete… more
- Beth Israel Lahey Health (Lawrence, MA)
- …Regular **Scheduled Hours:** 40 **Work Shift:** Day (United States of America) Clinical Supervisor (LICSW / LMHC) - Community Behavioral Health Center located in ... **Day 1 Benefits!** The Adult Urgent Care / MCI Clinical Supervisor oversees the day to day operations of...oversight of the clinicians. 4. Acts as first line consultant to clinicians for dispositions, especially for complex cases.… more
- Indian Health Service (Wadsworth, NV)
- …issues; providing administrative management and supervision for behavioral health staff and clinical supervision for appropriate staff to assure compliance with ... Summary The Supervisory Clinical Psychologist will report to the Chief Executive...operates within budgeted funding. Serves as an advisor and consultant on the programmatic aspects of all behavioral health… more
- Indian Health Service (Belcourt, ND)
- …programs. The purpose of the position is to function as the Deputy Clinical Director, and a Physician, which involves performance of related health and medical ... development of standard operating procedures and policies, including monitoring compliance and periodic review. Ensures policies, procedures, goals and objectives… more
- Kepro (Los Angeles, CA)
- …Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver ... partner for health solutions in the public sector. Acentra seeks aUtilization Clinical Reviewer - LCSW/LMFT/LPCC/LCPC (Remote within California) to join our growing… more
- SSM Health (St. Louis, MO)
- …Group, a member of SSM Health is seeking an anatomic and clinical pathologist for service at an academic campus. Other subspecialties, especially hematopathology ... or cytopathology, are welcome. Responsibilities include anatomic and clinical pathology, with hematopathology or cytopathology desirable but not required. Teaching… more
- Highmark Health (Charleston, WV)
- …with all divisions and departments within the corporate structure to provide clinical consultation and support with regard to program development, compliance ... utilized. As such, the incumbent's role is to provide clinical input into health care management services' activities including...familiar with network issues and how to act as consultant to physicians at hospitals and health care management.… more
- Community Wellness Partners (New Hartford, NY)
- …integrity. + Audits and monitors resident medical record for completeness and compliance . + Performs the clerical tasks for all admissions, transfers and/or ... required. + Obtains physician signatures if missing. + Brings clinical documents to the HIS office as needed. +...Maintains chart audits and monitoring as directed to assure compliance . + Maintains up to date Nursing assignment sheets… more
- SSM Health (Wentzville, MO)
- …for patient population. + Responsibility for maintaining a private office and all clinical decision making within the office during times of service. + Acts as ... an advisor and consultant in the establishment of operational policies of the...care plan participation; (3) Budget and practice expenses; (4) Medicare/ Medicaid participation; (5) Billing and collection of professional fees;… more
- Aveanna (Elkins Park, PA)
- …Aveanna Education Services, please connect to aveanna.com Essential Job Functions Clinical * Complete evidence based assessments and documents accordingly in ... electronic or paper medical records. * Provide clinical behavioral consultation to staff, school professionals, and parents/guardians, including case… more
- Indian Health Service (Shiprock, NM)
- Summary This position is located in the Division of Clinical Services, Pharmacy Branch, Northern Navajo Medical Center, Shiprock, NM. The purpose of this position is ... Service Chapter 39 and The Joint Commission(TJC)/Centers for Medicare & Medicaid Services (CMS) standards. Responsibilities The incumbent is responsible for… more
- SSM Health (St. Louis, MO)
- …responsibilities + Join a collaborative team under the Dept of Cardinal Glennon + Clinical Consultation for patients of all ages throughout the state of MO + ... Poison Center for the state of Missouri + Acts as an advisor and consultant in the establishment of operational policies of the practice to include: (1) Purchasing… more