Nurse Practitioner Family Medicine, Administrative Provider Solutions & DevelopmentNurse Practitioner Family Medicine, AdministrativeAnaheim, CA$183,822–$217,790 / yearIn addition, conducting telehealth visits once a week, a key success factor of this position is educating providers to improve the completeness, accuracy, and reliability of clinical documentation and HCC coding to accurately reflect the patient's true clinical picture. Famous for being the home of Disneyland Resort and the Los Angeles Angels baseball team, the city offers an escape from the bustle of city life, with multiple nature reserves, including Oak Canyon, Weir Canyon and the Anaheim Wetlands.
Emergency Department Charger/Coder University of CaliforniaEmergency Department Charger/CoderLos Angeles, CARemote$40.04–$52.83 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. You will assign ICD-10-CM and CPT/HCPCS codes for emergency department patients while ensuring accurate charge assignments using ASAP software within EPIC (CareConnect).
Clinical Documentation Integrity Specialist University of CaliforniaClinical Documentation Integrity SpecialistLos Angeles, CARemote$100,161.36–$218,718 / yearThis role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies. You will prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria, while identifying denial trends and root causes and provide feedback to the CDI and Clinical teams.
Senior Physician Assistant - Radiology UCSF Medical CenterSenior Physician Assistant - RadiologyCAKey responsibilities for this role include (but not limited to) the following: Billable inpatient evaluation and management (E&M) services including evaluation of new adult and pediatric inpatient consults, daily rounding on established IR patients, assistance with admission and discharge for primary IR patients and with care coordination for all IR patients across all UCSF campuses. UCSF APPs are expected to demonstrate accountability for their own clinical practice, participate in patient and staff education, serve as resources for APPs, APP students/fellows, physician residents/fellows, nurses and other staff, exhibit leadership skills, and engage in the mentoring of newly hired APPs.
Nurse Practitioner Family Medicine, Administrative Providence Health & ServicesNurse Practitioner Family Medicine, AdministrativeAnaheim, CA$183,822–$217,790 / yearJob ID Number: 31388 Facility Name: St. Joseph Heritage Medical Group Location Name: Anaheim Brand Name: Providence Provider Profession: Nurse Practitioner Medical Specialty: Family Medicine Job Setting: Medical Clinic Type of Role: Administrative Type of Role: Clinical Email: jamie.wright@psdrecruit.org In addition, conducting telehealth visits once a week, a key success factor of this position is educating providers to improve the completeness, accuracy, and reliability of clinical documentation and HCC coding to accurately reflect the patient''s true clinical picture.
Clinical Documentation Integrity Specialist Adventist Health SystemClinical Documentation Integrity SpecialistLos Angeles, CAJob Summary: Reviews, evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record and ensure it is in compliance with government and other regulations. Essential Functions: Evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record.
Certified Medical Coder Feed My People Food BankCertified Medical CoderLos Angeles, CaliforniaRemoteAfter work, you will find things to do in every season, including beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment. Under general supervision, according to established policies, procedures and protocols, codes all disease and operations according to accepted classifications.
Clinical Documentation Specialist Guidehouse IncClinical Documentation SpecialistLos Angeles, CA$74,000–$124,000 / yearInitiates compliant physician queries when documentation is confusing, ambiguous, or missing and follows up with MD to seek immediate response to query (utilizing the following AHIMA practice briefs as a guide: "Managing an Effective Query Process," October 2008 and "Guidance for Clinical Documentation Improvement Programs", May 2010). Reviews daily admissions to assigned unit, perform initial code assignment for a working DRG and complete CDI software data entry for initial and follows up case reviews (or worksheet to include code and DRG assignment) and submit to Program Assistant.
Internal Medicine Physician - Optum - Torrance, CA UnitedHealth Group IncInternal Medicine Physician - Optum - Torrance, CATorrance, CAClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Primary Care Physician - South Bay/Torrance - Optum UnitedHealth Group IncPrimary Care Physician - South Bay/Torrance - OptumTorrance, CA$237,361–$331,688 / yearOur Value Based Care model allows our clinicians the time needed to provide quality care to patients while supporting a healthy worklife balance Our model is designed to provide the most efficient comprehensive and proven care techniques to treat the whole patient - physically mentally and socially - at each visit. Clinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S.
Internal Medicine Physician - Laguna Hills UnitedHealth Group IncInternal Medicine Physician - Laguna HillsLaguna Hills, CAQuantity Model Average 18-22 patients per day Collaborate with a multi-disciplinary team of health care providers Daily administrative time built in Physicians schedule Comfortable seeing patients 18 years of age and older chronic disease management annual wellness checks routine screenings Appointment schedule 40 minutes for new consults and 20 minutes for in office visits screenings and follow-up appointments Dedicated Medical Assistant and office support so clinicians can focus on practicing at full scope of license. Clinical › Corporate and business operations › Customer and support services › Early careers› Sales and account management › Technology and data› Physicians› Advanced practice clinicians› Pharmacy› Behavioral health› Nursing› Medical coding› Clinical support› U.S. › Ireland & UK › India › Philippines › Culture of Belonging› Employee Benefits› Blog.
Optum CA, Rheumatologist-Pasadena, CA UnitedHealth Group IncOptum CA, Rheumatologist-Pasadena, CAPasadena, CAWhat makes an Optum Career different Be part of a best-in-class employee experience that enables you to practice at the top of your license We believe that better care for clinicians equates to better care for patients We are influencing change collectively on a national scale while still maintaining the culture and community of our local care organizations Practice medicine autonomously with the support not restrictions of a sustainable and thriving national health care organization. Clinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S.
Pharmacy Technician - Full Time UnitedHealth Group IncPharmacy Technician - Full TimeGardena, CAClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Internal Medicine Physician - Optum - Montebello, CA UnitedHealth Group IncInternal Medicine Physician - Optum - Montebello, CAMontebello, CAClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Medical Director, Utilization Management L.A. Care Health PlanMedical Director, Utilization ManagementLos Angeles, CAThis position plays a critical role in the mitigation of Fraud, Waste and Abuse (FWA) and requires proactive analysis of service level utilization data to identify trends, outliers and emerging risk areas and recommend corrective action to minimize utilization variation, prevent improper payments and ensure financial stewardship. Job Summary The Medical Director, Utilization Management provides clinical oversight of authorization decision making and processing, pre and post payment claims review activities, payment integrity clinical validation and program integrity functions.
NewClinical Documentation Integrity Specialist II - Hybrid FT Days Torrance Memorial Medical CenterClinical Documentation Integrity Specialist II - Hybrid FT DaysTorrance, CaliforniaUses clinical/nursing/coding knowledge to concurrently review and assess the medical record within 24-48 hours of admission including but not limited to physician documentation, lab and radiology results, nursing, nutrition, physical therapy and other provider’s documentation to determine that the most accurate severity of illness and expected risk of morality is reflected in the patient’s health record. Obtains additional documentation from physician or other qualified healthcare provider for clarification when there is conflicting, incomplete or ambiguous information in the healthcare record regarding any reportable data elements dependent on health record documentation.
Senior Director, Strategic Analytics Tendo Systems IncSenior Director, Strategic AnalyticsCARemote$2,024–$2,025This person will combine deep clinical informatics expertise with hands-on Databricks engineering and AI/ML skill to build algorithms that do two things simultaneously: (1) close documentation and coding gaps that affect risk adjustment, mortality index, and quality attribution, and (2) identify gaps and variation in the actual clinical processes of care that drive the metrics used by national hospital ranking and rating programs (e.g., CMS Star Ratings, U.S. News & World Report, Leapfrog, Vizient, Healthgrades, IBM Watson Health/Chartis 100 Top Hospitals). Maintain expert-level, current knowledge of major hospital ranking, rating, and benchmarking methodologies, including but not limited to: CMS Hospital Compare/Star Ratings, CMS Value-Based Purchasing and Hospital-Acquired Condition programs, U.S. News & World Report Best Hospitals methodology, Leapfrog Hospital Safety Grade, Vizient quality and safety benchmarking, Healthgrades, and payer-specific quality programs.
Medical Director, Clinical Policy L.A. Care Health PlanMedical Director, Clinical PolicyLos Angeles, CAThis position ensures clinical policies and utilization management frameworks are evidence-based, operationally sound, compliant with regulatory and accreditation requirements, and aligned with organizational goals related to quality, safety, affordability, and member experience. The Medical Director oversees policy architecture, authorization strategy, and utilization oversight across all lines of business, ensuring clinical intent is accurately translated into authorization requirements, coding structures, and system configuration through partnership with internal teams.
Supervisor, Benefit Distribution And Installation (50544) Western Growers AssociationSupervisor, Benefit Distribution And Installation (50544)Irvine, CAInterface with personnel in all field offices, TPA employers and brokers, and management staff as necessary to communicate any problems or issues with paperwork submission or installation issues for new business, plan changes, rate renewals and rate changes. Oversee the implementation of each new client with the third party administratorion (TPA) client, with necessary communication between the broker, PCMI operational areas, the client and any external vendor as necessary, including the review, completion & sign-off on Client Set-up Sheetsforms/screens.
Business Development Executive (MedInsight) Milliman IncBusiness Development Executive (MedInsight)Pasadena, CARemote$120,635–$199,065 / yearMedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions. Primary Responsibilities: Develop deep expertise in MedInsight's risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.