Average salary: $155,625 /yearly
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- ...as outlined by local administration, Adventist Health (AH), The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), and all other regulatory agencies. Maintains mammography services in accordance with standards established by the hospital and...CmsFull timeLocal areaDay shift
Adventist Health
Middletown, CA11 days ago $2,806 per week
...continued stay reviews is required. A strong understanding of medical necessity and retrospective reviews is necessary. Knowledge of CMS guidelines, CPT coding, ICD 10 coding, and DRG classifications is essential. The candidate should be well-versed in HEDIS measures,...CmsFull timeContract workShift workWeekend workCynet Health
Irvine, CA11 hours ago$2,578 - $2,622 per week
...accurate and timely clinical documentation in accordance with facility policies. Ensure compliance with California nursing regulations, CMS guidelines, and applicable healthcare standards. Requirements Requirements: Active California Registered Nurse (RN) license....CmsFull timeContract workImmediate startShift workPyramid Consulting, Inc.
Sunnyvale, CA8 days ago$2,959 per week
...planning. Candidates must have experience in appeals and denials processes and benefits eligibility. Knowledge of HIPAA guidelines and CMS regulations is essential. The registered nurse will work with a diverse patient demographic, including adolescents, adults,...CmsFull timeContract workShift workCynet Health
Eureka, CA4 hours agonew$2,725 per week
...Knowledge of admission criteria, benefits eligibility, and prior authorizations is necessary. Experience with disease management and CMS regulations is essential. The role may require arranging durable medical equipment and transport services. Flexibility is required...CmsFull timeContract workShift workWeekend workCynet Health
Apple Valley, CA11 hours ago$3,148 per week
...medical necessity evaluation, discharge planning, and prior authorization. Candidates must also be knowledgeable of HIPAA guidelines and CMS regulations. Work history verification and documentation of the last 7 years are necessary for compliance. Requirements...CmsFull timeContract workRemote workShift work3 days per weekCynet Health
San Francisco, CA11 hours ago$2,823 per week
...coordination Discharge Planning Utilize InterQual Criteria Utilization Review Admission Criteria Utilize InterQual Criteria Regulatory CMS: Centers for Medicare and Medicaid Services HIPAA guidelines (Health Insurance Portability and Accountability Act) Acute Hospital...CmsFull timeContract workShift workTalentBurst, Inc.
Petaluma, CA11 hours ago$190k - $220k
Job TitlePM/CM Services Owner's RepresentativeLocation4719 Viewridge Avenue, Suite 130, San Diego, CA, 92123, United StatesBase Pay$190,000.00 - $220,000.00 / YearIndustryConstruction, Owner's RepresentativeEmployee TypeExempt - FTRequired DegreeHigh schoolManage OthersYesMinimum...CmsKitchell
San Diego, CA1 day ago$2,825 per week
...Eligibility Care coordination Discharge Planning Disease management Needs Assessment/ Order DME Plan of Care Prior Authorizations Regulatory CMS: Centers for Medicare and Medicaid Services Department of Health DRG (Diagnosis Related Groups)The Joint Commission/ Core Measure/...CmsFull timeContract workImmediate startShift workTalentBurst, Inc.
Apple Valley, CA11 hours ago- Job DescriptionJob Description8 weeks. DAYS - 5x8 SCHEDULE: M-F - 8am to 4:30pmCare Coordinator inpatient.Must Be/Have: Experienced CM " a RN " Discharge planning assessment exp " Excellent UR " Psych social assessment skills " Acute hospital setting experience. Requires...Cms
IMCS Group
Pasadena, CA5 days ago - ...documentation to support safe, timely transitions from hospital to home or care facilities. The position requires a social work degree, CMS/Medicare knowledge, BLS, and strong communication. Collaboration with physicians, staff, and families is essential to ensure optimal...Cms
Southern California Hospitals
Culver City, CA1 day ago - ...Research AnalystThis position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). As a Social Science Research Analyst, GS-0101-12, you will develop and use survey, market research, and statistical methodologies...Cms
US Government Jobs
San Francisco, CA4 days ago - Job Description Job Description ****Must be located in CA! Will work remote but still attend trainings in LA and need to pick up equipment**** JOB REQUIREMENTS: -Experience: 1 year of CM exp - work comp exp required -CA LVN License -Certs: BLS -**FLU VACCINE...CmsRemote workShift workWeekend work
IMCS Group Inc
Beverly Hills, CA16 days ago $2,825 per week
...Eligibility Care coordination Discharge Planning Disease management Needs Assessment/ Order DME Plan of Care Prior Authorizations Regulatory CMS: Centers for Medicare and Medicaid Services Department of Health DRG (Diagnosis Related Groups)The Joint Commission/ Core Measure/...CmsFull timeContract workImmediate startShift workTravelNurseSource
Apple Valley, CA11 hours ago$59.84 - $94.46 per hour
...Magnet journey, and we were just awarded a 5-star rating for quality, safe care from the Centers of Medicare and Medicaid Services (CMS). Coordinates the provision of services for the Department of Imaging; assists in the planning, directing, and coordinating of activities...CmsMinimum wageFull timeLocal areaShift workProvidence
Santa Monica, CA9 days ago- ...thoroughly and advocate for post-hospital services as required. Role requires collaboration across disciplines, strong communication, and knowledge of CMS/Medicare guidelines. Expect HIPAA compliance and active participation in rounds and care planning. #J-18808-LjbffrCms
Southern California Hospitals
Culver City, CA2 days ago $2,875 per week
...Hospital Case Management/Utilization Review Care coordination Discharge Planning Plan of Care Utilize InterQual Criteria* Regulatory CMS: Centers for Medicare and Medicaid Services DRG (Diagnosis Related Groups)* " #TB_RN Why TalentBurst? At TalentBurst, we deliver...CmsFull timeContract workImmediate startShift workWeekend workTalentBurst, Inc.
Mission Hills, CA11 hours ago- ...Nursing Case ManagementAcute Nursing Case Management involving a core understanding and experience with Utilization Review (InterQual), Acute Discharge Planning and Proficiency with CMS Regulatory compliance for acute care settings (weekends, call): Every other weekend...CmsWeekend work
AMN Healthcare
Oakland, CA5 days ago - ...efforts. The role involves maintaining accurate provider records, coordinating outreach, and ensuring regulatory compliance across NCQA/CMS standards. The position offers remote work with a regional Newport Beach, CA office, with a salary range of $36,410.00 to $54,612.50...CmsWork at officeRemote work
Guardian Life
Newport Beach, CA4 days ago $2,795 per week
...Necessity per Evidence-Based Guidelines Discharge Planning Disease management Needs Assessment/ Order DME Plan of Care Regulatory CMS: Centers for Medicare and Medicaid Services CPT (Current Procedural Terminology) coding and billing Department of Health DRG (Diagnosis...CmsFull timeContract workImmediate startShift workWeekend workTalentBurst, Inc.
Burbank, CA11 hours ago$58.36 - $84.01 per hour
...Magnet journey, and we were just awarded a 5-star rating for quality, safe care from the Centers of Medicare and Medicaid Services (CMS). Responsible for performing patient scans under the supervision of a nuclear medicine physician. Duties include calculating radioisotope...CmsMinimum wageFull timeLocal areaShift workProvidence
Santa Monica, CA11 days ago- UnitedHealth Group is seeking a Clinical Documentation Improvement Specialist to work remotely from anywhere in the U.S. The role focuses on reviewing clinical records for accuracy and coding alignment, and collaborating with physicians to improve documentation. Candidates...CmsRemote work
UnitedHealth Group
Los Alamitos, CA3 days ago - ...readmission management support; physician engagement and education regarding utilization management, documentation, and applicable CMS and payer requirements. Other duties as assigned Qualifications # Doctorate from an accredited Medical or Osteopathic School...Cms
Long Tail Health Solutions
Long Beach, CA3 days ago - Case Management NurseProvides excellent patient care by assisting in the collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, physicians, multidisciplinary team and patient...CmsDay shift
Windsor Healthcare Recruitment Group
Glendale, CA1 day ago - ...requirements for medication storage. • Regulatory Compliance & Mock Surveys: Support survey readiness and ensure adherence to CMS and state health department guidelines. • Staff Education: Deliver in-service training and real-time coaching on safe...Cms
Tallis
Los Angeles, CA9 days ago - ...analyzing, and developing program documents. Review, evaluate, and analyze health insurance programs for efficiency and effectiveness. Review draft regulations and responses to CMS' proposed regulations. Assist with the administration of health insurance program audits....Cms
Department of Health and Human Services
San Francisco, CA3 days ago - East Los Angeles Doctor's Hospital in Los Angeles, CA seeks a part-time Nurse Case Manager (RN) to oversee clinical resource utilization and documentation affecting reimbursement. Under the CM Director, you will monitor patients, assess medical, financial, psychosocial...CmsPart time
East Los Angeles Doctors Hospital
Los Angeles, CA3 days ago $45.16 per hour
...hospital formulary appropriate to the patient population.QualificationsEDUCATION, EXPERIENCE, TRAINING1. Registered Dietitian Required (CMS requirement)2. One year healthcare experience desirable.Pay TransparencyEncino Hospital Medical Center offers competitive...CmsLocal areaPrime Healthcare
Encino, CA1 day ago$80k - $120k
Job Title PM/CM Services Owner's Representative Location 4719 Viewridge Avenue, Suite 130, San Diego, CA, 92123, United States Base Pay $80,000.00 - $120,000.00 / Year Industry Construction, Owner's Representative Employee Type Exempt - FT Required Degree High school Manage...CmsKitchell
San Diego, CA4 days ago- ...Job DescriptionJob DescriptionForhyre.com is looking for Zoho Engineers Essential Functions Design and implement Zoho CMS solutionsProvide Zoho CMS tuning and optimizationDevelop code with quality, scalability and extensibilityProvide work breakdown and estimates for development...Cms
forhyre.com
Sunnyvale, CA3 days ago
