- Humana (Sacramento, CA)
- …and regulations across Humana Specialty and Military products. The Director manages dedicated compliance teams of associates who oversee compliance ... Compliance to develop and implement compliance programs for Humana's Specialty and Military products and contracts. The Director is responsible for … more
- Humana (Sacramento, CA)
- …part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… 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 health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical… more
- Humana (Sacramento, CA)
- …our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. ... The Corporate Medical Director works on problems of diverse scope and complexity...necessity of services provided by other healthcare professionals in compliance with coverage policies, procedures, and performance standards. CMD… more
- Humana (Sacramento, CA)
- …our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The ... Corporate Medical Director works on problems of diverse scope and complexity...appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents… more
- Sacramento County (Sacramento, CA)
- …policies and procedures + Learn, comply with, and ensure staff compliance with laws, rules, regulations, protocols, and procedures, including security requirements, ... phase of the hiring process, please contact our Disability Compliance Office at ###@saccounty.gov or ###, CA Relay 711...of the total possible score as determined by the Director . APPEAL PROCESS: Persons who believe their applications have… more
- Sacramento County (Sacramento, CA)
- …policies and procedures + Learn, comply with, and ensure staff compliance with laws, rules, regulations, protocols and procedures, including security requirements, ... a valid hearing testing certificate, emergency first aid certificate and/or other specialty training appropriate to registered nurses and necessary in their job… more
- Sacramento County (Sacramento, CA)
- …certificate, hearing testing certificate, emergency first aid certificate, and/or other specialty training appropriate to Licensed Vocational Nurses and necessary in ... phase of the hiring process, please contact our Disability Compliance Office at ###@saccounty.gov or ###, CA Relay 711...of the total possible score as determined by the Director . APPEAL PROCESS: Persons who believe their applications have… more
- Sacramento County (Sacramento, CA)
- …a valid hearing testing certificate, emergency first aid certificate, and/or other specialty training appropriate to Registered Nurses and necessary in their job ... phase of the hiring process, please contact our Disability Compliance Office at ###@saccounty.gov or ###, CA Relay 711...of the total possible score as determined by the Director . APPEAL PROCESS: Persons who believe their applications have… more
- Rhythm Pharmaceuticals (Sacramento, CA)
- …for all approved indications. In Stage 1, this position will report to the National Director , ADMs, and in Stage 2, will transition to report to a US Field Sales ... Director . Responsibilities and Duties + Execute disease education to...with high levels of commitment and efficiency, including Healthcare Compliance training, expense reports and other assignments by established… more
- The Cigna Group (Sacramento, CA)
- …discharge/transfer to an alternate level of care. + Consults with manager and medical director to resolve any issues related to delay of services or barriers to ... exchange of information in order to manage the member's needs in compliance with all Federal/State/Facility contract and internal Cigna requirements. + Retrieves… more