- Sharp HealthCare (San Diego, CA)
- … Medical Director position provides critical management and oversight for Sharp Health Plan's (SHP) physicians ( Medical Directors (both medical ... and medical care and for all of Sharp Health Plan products, (Commercial, Exchange, Medicare,...of medicine. + 5 years' experience as an HMO Health Plan Medical Director . +… more
- Sharp HealthCare (San Diego, CA)
- …practices. **What You Will Do** Working with the Chief Medical Officer, oversees medical care for Sharp Health Plan (SHP) products and services and ... Reports all issues of clinical quality management to the health plan Chief Medical Officer. To ensure...in a managed care environment, preferably as an HMO Medical Director . + California Physicians and Surgeons… more
- Sharp HealthCare (La Mesa, CA)
- …Maximum):** $84.145 - $108.575 - $133.004 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay ... other requirements for the position, and employer business practices. Sharp Grossmont Hospital is proud to be Sharp...within that work unit and or programs. Assists the Director with operational planning and provides daily work direction… more
- Sharp HealthCare (San Diego, CA)
- …venues.Escalate and refers cases for consultation with Physician Advisor or Medical Director as appropriate.Oversee preparation, delivery and documentation of ... **Facility:** Sharp Memorial Hospital **City** San Diego **Department** **Job...Professional Nurses Network, United Nurses Associations of California/Union of Health Care Professionals, NUHHCE, AFSME, AFL-CIO. Placement within the… more
- Sharp HealthCare (La Mesa, CA)
- …admission, including requests for outpatient care, retrospective claim review, durable medical equipment, medication issues and acquisition, home health , in ... $38.948 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The...+ HS Diploma or Equivalent **Preferred Qualifications** + Additional health related education + Successful completion of Medical… more
- Sharp HealthCare (San Diego, CA)
- … care professionals in providing quality care to patients in the Sharp Rees-Stealy Occupational Health Program. **Required Qualifications** + Certification of ... **FTE** 0 **Shift Start Time** **Shift End Time** Certified Medical Assistant (CMA) - California Certifying Board for ...Performs all other duties as required by Coordinator, Occupational Health Nurse or Director . Times patient in… more
- Sharp HealthCare (San Diego, CA)
- …and/or Case Manager.Identifies and refer requests for review by higher level staff ( Medical Director , Hospitalist or CM) within department turn-around time (TAT) ... health care field, preferably HMO or delegated risk medical group/IPA setting. + 1 Year experience with ...the denial process - gathers documentation after review by medical director , ensure that all information is… more
- Sharp HealthCare (San Diego, CA)
- …for medical necessity are issued under the direction of the Medical Director or designee.Assists with transfers, when necessary. + Demonstrates knowledge ... $52.303 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The...Year experience in the acute patient care, SNF, home health , or hospice settings. + Experience as a case… more
- Sharp HealthCare (San Diego, CA)
- …Care Coordinator level of review.Appropriately identify claims for review by the Medical Director to include obtaining the appropriate medically necessary ... the eMD for and forward the claim with all applicable information to the Medical Director . + Quality and Productivity PerformanceAchieve 90% or greater quarterly… more