We interpreted Mountain View, CA as Mountain View, CA. Other options include: Mountain View (Contra Costa County), CA
- 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
- 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)
- …of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management , a ... autism and depression, and insightful analytics to improve the delivery of care . The **Network Management Representative** provides comprehensive services to the… 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
- Elevance Health (Palo Alto, CA)
- …applicable state(s) or territory of the United States and minimum of 2 years acute care clinical experience. For candidates working in person or remotely in the ... care and accurate claims payment. May also manage appeals for services denied. Primary duties may include, but...directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process. +… more