- 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
- Elevance Health (Walnut Creek, CA)
- …+ **Costa Mesa** + **Palo Alto** + **Walnut Creek** The **Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and appeals ... clinical decisions, pharmacy on pre-service and post service appeals and grievances related to non- clinical and...clinical services, quality of service and quality of care issues including executive and regulatory grievances. + Oversees… more
- Elevance Health (Walnut Creek, CA)
- … and non clinical services, quality of service, and quality of care issues to include executive and regulatory grievances. **How you will make an impact:** ... management review activities which require the interpretation of clinical information. + The analyst may serve as a...analyst may serve as a liaison between grievances & appeals and /or medical management , legal, and/or… more
- Alameda Health System (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
- Alameda Health System (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
- Alameda Health System (San Leandro, CA)
- …CA + San Leandro Hospital + SLH Social Services + Full Time - Day + Care Management + Req #:40181-29621 + FTE:1 + Posted:October 31, 2024 **Summary** **Job ... health deterioration and reduce the need for more costly services such as acute care hospitalization and to develop self- management skills that improve his or… more
- Alameda Health System (Alameda, CA)
- …+ Alameda Hospital + AH Care Coordination + Full Time - Day + Care Management + Req #:40760-30098 + FTE:1 + Posted:November 7, 2024 **Summary** **SUMMARY:** ... health deterioration and reduce the need for more costly services such as acute care hospitalization and to develop self- management skills that improve his or… more