PicoRiveraRecruiter Since 2001
the smart solution for Pico Rivera jobs

Clinical Compliance Medical Director

Company: Anthem Inc.
Location: Pico Rivera
Posted on: May 7, 2020

Job Description:

SCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.This is an exceptional opportunity to do innovative work that means more to you and those we serve at of Americas leading health benefits companies and a Fortune Top 50 Company.Anthem, Inc. is ranked as of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.*This position will travel around 50% of the time.Responsible for providing clinical guidance related to the company's coding guidelines, provider coding audits, and participates in developing an investigation team that focuses on potential fraud, waste and abuse in the provider population.Primary duties may include, but are not limited to:Reviews provider record documentation to determine if there is potential fraud, waste, or abuse that warrants further investigations.Conducts provider interviews related to these investigations.Reviews investigative material which includes provider record documentation.Provides clinical guidance regarding coding guidelines and develops provider educational material.Provide input and assist with developing a more clinically focused provider audit process to obtain more meaningful results.Develops clinical review for investigations team including developing guidelines on how to implement the clinical analysis portion of the investigations and developing clinically relevant questions for provider interviews.Develops provider educational materials that are clinically focused and provides peer-to-peer compliance training and education to other providers internally and externally.Provides input to provider reporting from the provider perspective.An Equal Opportunity Employer/Disability/VeteranQualificationsM.D. or D.O.; certification approved by the American of Specialties required where applicable to duties being performed.Requires active unrestricted license to practice medicine or a health profession.Clinical training and practice as a primary care physician required.5 of clinical experience; or any combination of education and experience, which would provide an equivalent background.coding certification (AAPC or AHIMA) preferred.An Equal Opportunity Employer/Disability/VeteranREQNUMBER: PS35679

Keywords: Anthem Inc., Pico Rivera , Clinical Compliance Medical Director, Healthcare , Pico Rivera, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Non-Emergency-Medical-Transport Driver
Description: At Veyo, we help people get to and from their healthcare appointments. We''re looking for drivers to partner with us in your area. When you sign up to drive with Veyo, you can drive your own vehicle and (more...)
Company: Veyo
Location: Placentia
Posted on: 06/2/2020

Permanent Neurology Physician in Palm springs, California
Description: Neurology physician employment in California : CompHealth is currently seeking a Neurology Physician in CA A new epilepsy physician opportunity is now available in California at a growing medical center. (more...)
Company: CompHealth
Location: Palm Springs
Posted on: 06/2/2020

Rheumatology Opening 30mnts from Los Angeles
Description: Rheumatology opening in Redlands, California. This and other physician jobs brought to you by DocCafe.com Established health system seeks a full time Rheumatologist to join busy team outside Los Angeles, (more...)
Company: Britt Medical Search
Location: Redlands
Posted on: 06/2/2020


Radiology Opening 30 mnts from Los Angeles
Description: Radiology opening in Redlands, California. This and other physician jobs brought to you by DocCafe.com Established health system seeks a full time Radiologist to join busy team outside Los Angeles, CA. (more...)
Company: Britt Medical Search
Location: Redlands
Posted on: 06/2/2020

Invasive Cardiologist needed close to Los Angeles
Description: Cardiology-Invasive opening in Redlands, California. This and other physician jobs brought to you by DocCafe.com Invasive non-interventional Cardiologist wanted north of Los Angeles in two affiliated (more...)
Company: Britt Medical Search
Location: Redlands
Posted on: 06/2/2020

Hcr Manorcare Inc. Director Of Nursing Hospice - HCR Manorcare Inc.
Description: Hcr Manorcare Inc. Director Of Nursing Hospice - HCR Manorcare Inc.DescriptionWanted: Top notch, quality obsessed, team-oriented, and compassionate nurse leader The Director of Nursing is responsible (more...)
Company: HCR ManorCare Inc.
Location: Tustin
Posted on: 06/2/2020

OBGYN Opening 30mnts from Los Angeles
Description: Obstetrics Gynecology opening in Redlands, California. This and other physician jobs brought to you by DocCafe.com Established health system seeks a full time clinical OBGYN to join busy team outside (more...)
Company: Britt Medical Search
Location: Redlands
Posted on: 06/2/2020

Non-Emergency -Medical -Transport Driver
Description: At Veyo, we help people get to and from their healthcare appointments. We're looking for drivers to partner with us in your area. When you sign up to drive with Veyo, you can drive your own vehicle and (more...)
Company: Veyo
Location: Aliso Viejo
Posted on: 06/2/2020

HCR ManorCare Inc.: Director of nursing - hospice
Description: DescriptionWanted: Top notch, quality obsessed, team-oriented, and compassionate nurse leader The Director of Nursing is responsible for the overall clinical operation of the Hospice agency. This role (more...)
Company: HCR ManorCare Inc.
Location: Laguna Niguel
Posted on: 06/2/2020

Interventional Radiology Opening 30 mnts from Los Angeles
Description: Radiology-Interventional opening in Redlands, California. This and other physician jobs brought to you by DocCafe.com Established health system seeks a full time Interventional Radiologist to join busy (more...)
Company: Britt Medical Search
Location: Redlands
Posted on: 06/2/2020

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Pico Rivera RSS job feeds