NewSupervisor, Nurse Practitioner Molina HealthcareSupervisor, Nurse PractitionerSan Diego, CA$111,893–$218,192 / yearSupervises and mentors a team focused on primary, urgent, and preventative care services in various non-clinical community settings such as homes, nursing facilities, shelters, and pop-up clinics, in any environment where members feel most comfortable and are receptive to care that aligns with Molina Healthcare’s philosophy and mission. Actively participates in and leads regional meetings hosted by managers, peers, senior leadership team and other department leads including workshops, townhalls, huddles, new programs, new pilots, and initiatives.
Associate Director, Medical Review Lead, MSRM - Remote Agios PharmaceuticalsAssociate Director, Medical Review Lead, MSRM - RemoteSan Diego, CARemote$185,369–$308,948 / yearThe current base salary range for this position is expected to be between $185,369 and $308,948 annualized; final salary will be determined based on various factors including, but not limited to, years of relevant experience, job knowledge, skills and proficiency, degree/education, and internal comparators. This role provides oversight of medical review for Individual Case Safety Reports (ICSRs) across investigational and marketed products, ensuring medical accuracy, regulatory compliance, and high-quality safety data to support pharmacovigilance and risk management activities.
Accounts Receivable Lead SarnovaAccounts Receivable LeadSan Diego, CAThe A/R Management Lead also serves as a subject matter expert, identifying process improvements to increase efficiency within the A/R Management team, and acting as a resource to help team members resolve issues. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle.
Billing Manager - Digitech SarnovaBilling Manager - DigitechSan Diego, CAAdditional responsibilities include identifying deficiencies within the group and escalating them to the Director, building positive relationships both internally and externally, maintaining Key Performance Indicators (KPIs), and delivering annual reviews with staff, along with corrective actions when necessary. The A/R Management Manager is responsible for directly managing the ARM team and ensuring that outstanding accounts, denials, and appeals are accurate and followed up on in a timely manner to maximize reimbursements.
NewAmbulatory Coding Compliance Auditor (CPC/CCS-P) Sharp HealthCareAmbulatory Coding Compliance Auditor (CPC/CCS-P)San Diego, CAThe role requires strong knowledge of CPT and ICD-10 codes, exceptional communication skills, and the ability to train clinical staff. The ideal candidate has 3 years of experience in a healthcare setting and holds a CPC or CCS-P certification.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321San Diego, CAIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
Part-time Adjunct Faculty/Developer for Artificial Intelligence Coding and Programming DetailsPart-time Adjunct Faculty/Developer for Artificial Intelligence Coding and ProgrammingSan Diego, CaliforniaDetailed Description: The University of San Diego's Professional and Continuing Education department is seeking an adjunct faculty member with mastery in the application of artificial intelligence for coding and programming for business solutions. Governed by an independent board of trustees since 1972, USD remains committed to a liberal arts education grounded in the Catholic intellectual tradition and the pursuit of truth, goodness and beauty.
Radiology Coding Supervisor - Remote University of CaliforniaRadiology Coding Supervisor - RemoteSan Diego, CARemoteUC San Diego is a student-centered, research-focused, service-oriented public institution recognized as one of the top fifteen research universities worldwide, and a top ten public university. 15 years later, my work improves operational efficiencies, provides valuable programs to the university, and even helps students bring their innovations to life.
Director, Permitting & Code Enforcement (Administrator II) California State UniversityDirector, Permitting & Code Enforcement (Administrator II)San Diego, CA$172,000–$192,000 / yearThis position partners closely with campus leadership, Facilities Services, Project Management, Planning, Design & Construction, Housing, Academic Affairs, Student Affairs + Campus Diversity, and external agencies to help deliver safe, efficient, and innovative campus environments that support SDSU's academic mission and long-term growth. Reporting to the Associate Vice President of Real Estate, & Planning Development and Campus Deputy Building Official, this role leads the University's permitting, inspection, and code enforcement functions in support of SDSU's growing portfolio of capital improvement, infrastructure, and public works projects.
Director, Permitting & Code Enforcement (Administrator II) CSU CareersDirector, Permitting & Code Enforcement (Administrator II)San Diego, CaliforniaThis position partners closely with campus leadership, Facilities Services, Project Management, Planning, Design & Construction, Housing, Academic Affairs, Student Affairs + Campus Diversity, and external agencies to help deliver safe, efficient, and innovative campus environments that support SDSU’s academic mission and long-term growth. Reporting to the Associate Vice President of Real Estate, & Planning Development and Campus Deputy Building Official, this role leads the University’s permitting, inspection, and code enforcement functions in support of SDSU’s growing portfolio of capital improvement, infrastructure, and public works projects.
STEM & Coding Teaching Opportunities Concorde EducationSTEM & Coding Teaching OpportunitiesImperial Beach, San Diego County$50–$100 / hourPreferred qualifications include: • At least 60 college credits, where required by the applicable assignment or site; • Experience with coding, programming, computer science, or related technology subjects; • Experience teaching, tutoring, coaching, mentoring, or leading activities with school-age students; • Strong communication, organization, and classroom facilitation skills; • Availability to provide services for the accepted assignment schedule and communicate schedule issues as soon as reasonably practicable; and. Payment for completed services is generally made by direct deposit on the fifteenth day of the month following the month in which services were completed, unless otherwise stated in the accepted assignment terms or required by applicable law.
Urgent Care - Partner Veterinarian - San Diego , {State_Code UsvtaUrgent Care - Partner Veterinarian - San Diego , {State_CodeSan Diego, CaliforniaAn exceptional veterinary hospital, with a dedicated team, is seeking an experienced Partner Veterinarian to provide leadership, superior patient and client care, and financial ownership in the hospital. The ideal leader for this hospital is a veterinarian who is prepared to manage a team of doctors and medical staff and successfully oversee the clinical direction of the practice while building equity.
Director, Permitting & Code Enforcement (Administrator II) San Diego State UniversityDirector, Permitting & Code Enforcement (Administrator II)San Diego, CaliforniaThis position partners closely with campus leadership, Facilities Services, Project Management, Planning, Design & Construction, Housing, Academic Affairs, Student Affairs + Campus Diversity, and external agencies to help deliver safe, efficient, and innovative campus environments that support SDSU’s academic mission and long-term growth. Reporting to the Associate Vice President of Real Estate, & Planning Development and Campus Deputy Building Official, this role leads the University’s permitting, inspection, and code enforcement functions in support of SDSU’s growing portfolio of capital improvement, infrastructure, and public works projects.
NewMedical Biller Modena Allergy + AsthmaMedical BillerSan Diego, CARemoteModena Health ("MH") and Modena Allergy & Asthma ("MAA") are leading and rapidly growing medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona—and ambitious plans for national expansion. Our model combines hospitality-driven service with innovative technology solutions that streamline operations, improve clinical outcomes, and enhance the experience for both patients and providers.
NewMedical Billing Integrated Resources, IncMedical BillingSan Diego, CAThe role requires reviewing clinical documentation, applying payer-specific medical necessity criteria, and ensuring alignment between CPT and ICD-10 coding. Excellent communication and customer service skills; cooperative, work collaboratively and treat others in respectful, professional and supportive manner.
Billing Specialist II Prometheus Laboratories IncBilling Specialist IISan Diego, CAThe Billing Specialist II will be responsible for supporting financial objectives through strategic and tactical activities, actively engaging with payors, providers, and patients, resulting in the highest-level reimbursement on submitted claims. Filing appeals when appropriate to obtain maximum reimbursement, establish and maintain strong relationships with providers, clients and fellow staff, and monitor trend in denials of payment changes.
Medical Biller APEX RECOVERYMedical BillerSAN DIEGO, CAAudit and evaluate clinical documentation and billing records to ensure they are accurate, timely, clinically appropriate, justify medical necessity for Medi-Cal reimbursement, and comply with all State and County documentation and billing requirements. Run reports from the designated electronic health record (EHR) to assist program in complying with County and state documentation and billing requirements, perform data validation, and conduct quality control checks.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorCA$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Part Time Instructor Pool - Business Office Technology The Grossmont-Cuyamaca Community College DistrictPart Time Instructor Pool - Business Office TechnologySan Diego, CaliforniaAs such, the District is committed to eliminating achievement gaps among different student groups by promoting a culture of appreciation for diversity, equity, inclusivity, and social justice, and continuously examining our processes and practices through an equity lens. It happens every day with our 30,000 students who take the first step in their higher education, become trained for a new career, or learn knowledge that transforms their world perspective.
Medical Accounts Receivable Specialist 2 Hologic IncMedical Accounts Receivable Specialist 2San Diego, CAThis position analyzes denial trends and payer performance, investigates rejected claims, collaborates with internal teams and providers, and supports departmental financial goals such as cash collections and DSO. Can live anywhere within the territory region* The Strategic Service Manager will coordinate Breast & Skeletal Health (BSH) SureCare sales efforts within assigned territory to achieve annual quota.
Office Manager- Outpatient Acadia Healthcare Co IncOffice Manager- OutpatientEl Cajon, CA$27–$30 / hourJob Responsibilities: Administrative supervision, leadership, guidance, and feedback to administrative staff in order to facilitate smooth operations of the clinic while maintaining appropriate coverage, scheduling and training; Establishes, maintains, and retrieves general files for clinic leadership; Manages and coordinates administrative programs and office activities; Develops procedures and policies for office activities and training; May work with Clinic Director to plan community outreach events; May attend staff meeting, take notes and prepare minutes, as required by clinic leadership; Prepares and distributes correspondence, interoffice memorandums, contracts, forms, and reports; May submit purchase orders as required; May assist in monitoring clinical staff credentialing process, including collection of documentation, verification of credentials, and licenses, as directed; May share responsibility for completing insurance information on vehicle accidents and abuse allegations and injuries of patients; and, Perform other duties as assigned. Our Team: El Cajon Comprehensive Treatment Center (CTC), located in EL Cajon, Ca, is part of Acadia Healthcare''s Comprehensive Treatment Centers, the leading provider of medication-assisted treatment in the nation.
Hospital Billing Operator Deloitte Touche Tohmatsu LtdHospital Billing OperatorCA$70,000–$90,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Manager, Revenue Integrity&Formulary Strategy Xifin IncManager, Revenue Integrity&Formulary StrategySan Diego, CA$90,000–$137,000 / yearYou will serve as a revenue integrity and compliance subject matter expert (SME), responsible for ensuring XiFin customer formularies, drug lists, and utilization management criteria are designed, implemented, and maintained to support accurate charge capture, compliant billing, and defensible reimbursement. This role applies deep regulatory, coding, and payer policy expertise to mitigate financial and compliance risk, support audit defense and denial management activities, and ensure alignment with organizational revenue integrity strategy and compliance requirements.
Revenue Cycle Manager Balboa United, LLCRevenue Cycle ManagerSan Diego, CAPart timeThis is an ideal opportunity for an individual experienced in full revenue cycle operations for 10 or more physicians/APPs, has been responsible for the Revenue Cycle Management (RCM) functions, has leadership experience, and enjoys being close to the work: hands-on, coaching supervisors and staff, solving operational problems, and owning results. In general, this position requires the ability to lift up to 35 pounds unassisted; ability to stand for extended periods of time and to perform repetitive stooping, walking, stretching, reaching and some sitting; ability to use full range of body motions required to lift patients, wear a lead apron, and lift and move supplies.
Revenue Cycle Manager Balboa Care Nephrology Research Enterprise UnitedRevenue Cycle ManagerSan Diego, CaliforniaThis is an ideal opportunity for an individual experienced in full revenue cycle operations for 10 or more physicians/APPs, has been responsible for the Revenue Cycle Management (RCM) functions, has leadership experience, and enjoys being close to the work: hands-on, coaching supervisors and staff, solving operational problems, and owning results. In general, this position requires the ability to lift up to 35 pounds unassisted; ability to stand for extended periods of time and to perform repetitive stooping, walking, stretching, reaching and some sitting; ability to use full range of body motions required to lift patients, wear a lead apron, and lift and move supplies.
Senior Medical Assistant- Vista CA UnitedHealth Group IncSenior Medical Assistant- Vista CAChula Vista, CAAdministrative Duties Responsible for routine and basic front and back-office duties to include answering phones scheduling and confirming appointments preparing schedules data entry including referral contracts post appointment information prefill document retrieval filing performing data entry and assisting in the examination process of patients under the direction of a physician or other licensed provider. Collaboration and Compliance Partner with Clinical Quality Leadership and other healthcare professionals to ensure compliance with all clinical policies and training programs maintain and enhance quality assurance processes adhere to best practices and clinical guidelines participate in performance improvement initiatives engage in continuous professional development.
Technical Product Manager Veracyte IncTechnical Product ManagerSan Diego, CARemote$148,000–$160,000 / yearOur Veracyte Diagnostics Platform delivers high-performing cancer tests that are fueled by broad genomic and clinical data, deep bioinformatic and AI capabilities, and a powerful evidence-generation engine, which ultimately drives durable reimbursement and guideline inclusion for our tests, along with new insights to support continued innovation and pipeline development. In addition to core product management duties, the Technical Product Manager will collaborate closely with engineering, clinical, and analytics teams todeliver scalable, automation‑driven solutions that enable accurate billing, faster reimbursement, and data‑driven decision‑making.
Medical Scribe La Maestra Family Clinic IncMedical ScribeNational City, CA$23–$29 / hourTechnical knowledge and skills required to perform the job: Excellent verbal, written and interpersonal communication skills and the demonstrated ability to work with diverse individuals and groups. Collaborate with individual patients, their personal physicians, and when appropriate the patient's family to ensure accessible, comprehensive, compassionate, and culturally competent care.
NewInpatient Coder TalentFish LLCInpatient CoderSan Diego, CARemote$35–$40 / hourAll offers are contingent upon the completion of a background check, which may include but is not limited to, reference checks, education verification, employment verification, drug testing, criminal records checks, and any required certifications or compliance requirements based on the end client's background check policies and applicable laws. The Inpatient Coder will ensure accurate and compliant coding of inpatient records, contributing directly to quality data reporting, reimbursement, and overall patient care documentation integrity.
Billing & Collections Representative II (Casual) - PFS - RCSSD Rady Children's HospitalBilling & Collections Representative II (Casual) - PFS - RCSSDSan Diego, CA$23.10–$31.77 / hourJOB SUMMARY: Under the direction of the Manager Professional Billing & Coding, the Billing & Collections Representative II (BCII) is responsible for the resolution of all outstanding balances from all payors, including but not limited to; Commercial, Medi-Cal and Managed Care professional claims. This incumbent is expected to accurately analyze each denial received by reviewing the patient account, the remittance codes from Explanation of Benefits (EOB) and Remittance Advice (RA).
Billing & Collections Representative II - PFS - RCSSD Rady Children's HospitalBilling & Collections Representative II - PFS - RCSSDSan Diego, CA$23.10–$31.77 / hourJOB SUMMARY: Under the direction of the Manager Professional Billing & Coding, the Billing & Collections Representative II (BCII) is responsible for the resolution of all outstanding balances from all payors, including but not limited to; Commercial, Medi-Cal and Managed Care professional claims. This incumbent is expected to accurately analyze each denial received by reviewing the patient acct, the remittance codes from Explanation of Benefits (EOB) and Remittance Advice (RA).
PACE Medical Coder (Hybrid) San Ysidro Health CenterPACE Medical Coder (Hybrid)San Diego, CAPosition Summary: The PACE Medical Coder will review clinical documentation and diagnostic results as necessary to verify the appropriate assignment of the ICD-10 CM, CPT and HCPCS codes as per Official Guidelines for Coding and Reporting. Almost 50 years later, San Ysidro Health now provides innovative care to over 108,000 patients through a vast and integrated network of 47 program sites across the county.
Coder - SRS - Cardio Thoracic Sharp Health PlanCoder - SRS - Cardio ThoracicSan Diego, CA$30.37–$37.95 / hourThe actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. Demonstrates the ability to request, review and code medical services from reports and notes in order to convert procedural and diagnostic notes into appropriate levels of care following coding rules and regulations.
Director, Revenue Cycle Management Tandem Diabetes Care IncDirector, Revenue Cycle ManagementCA$161,000–$205,000 / yearA track record for successfully defining the appropriate structure, personnel, processes, and measurements to successfully meet the company's billing and collection needs and making the requisite changes as the company's needs change. A DAY IN THE LIFE: The Director, Revenue Cycle Management (RCM) is an integral part of the financial operations' infrastructure, creating and implementing policies and best practices for the billing and reimbursement function and ensuring that billing and collection activities are timely and accurate.
Supervisor of Billing Balboa United, LLCSupervisor of BillingSan Diego, CAPart timeIn addition to office and hospital-based patient care, Balboa physicians manage the dialysis treatments of approximately 4,500 patients at 88 dialysis centers and conduct Nephrology based clinical research at 6 centers throughout Imperial and San Diego counties (California Institute of Renal Research). In general, this position requires the ability to lift up to 35 pounds unassisted; ability to stand for extended periods of time and to perform repetitive stooping, walking, stretching, reaching and some sitting; ability to use full range of body motions required to lift patients, wear a lead apron, and lift and move supplies.
Medical Biller - Ophthalmology La Jolla LASIK InstituteMedical Biller - OphthalmologyLa Jolla, CAWith a highly personalized and medically world-class system of patient care, La Jolla LASIK Institute makes dreams come true for people frustrated with the limitations of glasses and contact lenses. If you feel you are an outstanding, professional medical biller and would like to join a dynamic, growing company, please submit your resume, cover letter, and a joke (so we know you read all the way to the bottom and are not just spamming us) through the website.
Medical Director/Associate Medical Director (U.S. Remote) Confidential CompanyMedical Director/Associate Medical Director (U.S. Remote)San Diego, CARemoteData Surveillance : Conduct ongoing medical review of coded data, including adverse events, laboratory results, and tumor assessments (using iRECIST or irRC ) to identify safety signals or trends. Lead the medical drafting and review of periodic safety reports, including Development Safety Update Reports (DSUR) , PBRERs, and Suspected Unexpected Serious Adverse Reactions ( SUSARs ).
Reimbursement Specialist PST Time Zone Veracyte IncReimbursement Specialist PST Time ZoneSan Diego, CARemote$25–$31 / hourOur Veracyte Diagnostics Platform delivers high-performing cancer tests that are fueled by broad genomic and clinical data, deep bioinformatic and AI capabilities, and a powerful evidence-generation engine, which ultimately drives durable reimbursement and guideline inclusion for our tests, along with new insights to support continued innovation and pipeline development. Your primary role will be to take part in the day-to-day operations of the insurance billing life cycle to facilitate a smooth reimbursement process (i.e., verifying patient insurance coverage and benefits, ensuring timely insurance claim submissions, payment posting, performing A/R Follow-Up, sending appeals et al.).
Supervisor of Billing Balboa Care Nephrology Research Enterprise UnitedSupervisor of BillingSan Diego, CaliforniaIn addition to office and hospital-based patient care, Balboa physicians manage the dialysis treatments of approximately 4,500 patients at 88 dialysis centers and conduct Nephrology based clinical research at 6 centers throughout Imperial and San Diego counties (California Institute of Renal Research). In general, this position requires the ability to lift up to 35 pounds unassisted; ability to stand for extended periods of time and to perform repetitive stooping, walking, stretching, reaching and some sitting; ability to use full range of body motions required to lift patients, wear a lead apron, and lift and move supplies.
NewEligibility Coordinator Astera Cancer CareEligibility CoordinatorSan Diego, CA$21–$24 / hourJob Description Objective: This position verifies patient insurance coverage, obtains authorizations, and resolves billing‑related issues, bridging the gap between patients, medical staff, and insurance companies. Identify issues and trends impacting patient care, quality, and timely reimbursement; report findings and potential solutions to leadership.
NLP Engineer UnitedHealth Group IncNLP EngineerSan Diego, CA$72,800–$130,000 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. The Sr NLP Engineer works closely with other NLP engineers, NLP developers, software engineers, and subject matter experts on current company technologies and forward-looking projects.
Director of Health Information Management (RHIA) Aurora San DiegoDirector of Health Information Management (RHIA)San Diego, CA$75,000–$85,000As the Director of Health Information Management, for Aurora San Diego, you will be responsible for supervising and coordinating the activities concerning analyzing, compiling, abstracting, transcribing, coding, indexing, and filing patient records. Calculate and send Fall audit, Read back audit, timeliness of Psychiatric Evaluation audit, Pre-Discharge Evaluation of Risk audit, and discharge diagnosis.
NewIR Technologist Intermountain HealthIR TechnologistSan Diego, CA35.60 - $54.93 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. As an Interventional Radiology Technologist, you’ll play a hands‑on role in cutting‑edge diagnostic and interventional procedures—circulating, scrubbing, monitoring, and operating advanced IR imaging systems.
NewNuclear Medicine PET CT Technologist Intermountain HealthNuclear Medicine PET CT TechnologistSan Diego, CAFrequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations. $43.09 - $66.47 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
NewInterventional Radiology Technologist $15,000 Bonus Intermountain HealthInterventional Radiology Technologist $15,000 BonusSan Diego, CAFrequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations. $39.16 - $60.42 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Revenue Cycle Manager el cajon cross ESRhealthcare and EXEC STAFF RECRUITERSRevenue Cycle Manager el cajon crossEl Cajon, CaliforniaThe Revenue Cycle Manager will oversee all aspects of the revenue cycle process, including insurance verification, coding, charge entry, claims submission, collections, payment posting, denial management, and regulatory compliance. This is an exciting opportunity for a healthcare revenue cycle professional who thrives in process improvement, operational leadership, and building high-performing teams.
Billing and Accounts Receivable Manager Deloitte Touche Tohmatsu LtdBilling and Accounts Receivable ManagerCARemote$140,000–$160,000 / yearAs an Epic Billing and Accounts Receivable Manager you will help deliver back-end revenue cycle management (RCM) services, including billing and claims submission, A/R follow-up, denials management, payment posting, and credits and refunds, for health care provider client. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Clinical Documentation Improvement Specialist Sharp Health PlanClinical Documentation Improvement SpecialistSan Diego, CA$57.74–$74.49 / hourDemonstrates positive interpersonal relations in dealing with all members of the team (i.e. co-workers, supervisors, physicians, etc.) as evidenced by: communicating in a positive and productive manner; demonstrating respect for team members; maintaining a positive attitude; about assignments and team members; and working collaboratively; and cooperating with other departments/units. Improves accuracy documentation specificity and completeness with real-time interactive communication and education of physicians, clinicians, and other involved parties regarding the necessity of providing complete and clear documentation of the care provided throughout a patient's stay.
Care Management - Nurse, Senior (CA Children''s Services) Blue Cross and Blue Shield AssociationCare Management - Nurse, Senior (CA Children''s Services)San Diego, CAIn this role, you will: Perform complex care management/care management/care coordination for members using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medi-Cal and CCS/EIES/DDS/CSHCN/EPSDT Eligibility guidelines. Responsible in assisting and working daily inventory, providing high-quality clinical reviews, performing efficient care management and care coordination, and ensuring compliance performance metrics are met.
NewPrior Authorization Specialist Hologic IncPrior Authorization SpecialistSan Diego, CAThe Business Development Lead, Diagnostics Solutions Division, will work closely with the Division's VP, Global Business Development and Strategy, and the Diagnostics leadership team to identify, evaluate, and cultivate. As a Quality Programs Manager 4, you will be a key leader responsible for ensuring regulatory compliance, driving continuous improvement, and embedding industry best practices across our Quality Management System (QMS).