- TEKsystems (Los Angeles, CA)
- …Vocational Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims processes. ... provider and member claims for accuracy and compliance + Review and process claims in accordance with UM guidelines...RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with HMO/Medicare claims,… more
- Deloitte (Los Angeles, CA)
- …clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk...financial concerns and other business controversy. A Clinical Documentation Specialist (CDS) works to ensure accuracy and completeness of… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Sharp HealthCare (San Diego, CA)
- …**What You Will Do** The purpose of the Sr. Performance Improvement Specialist is to improve clinical outcomes including responsibilities relating to leading teams ... in the utilization of Change Acceleration Process and PI tools and...through measurement and analysis along with concurrent and retrospective review of performance information. Assists with operational planning and… more
- University of Southern California (Los Angeles, CA)
- The Clinical Nurse Specialist serves as a resource/consultant for all departments regarding clinical specialty, conducts/ participates in research across varied ... initiatives. Integrate research and evidence based practice into the development, review and revision of patient education materials. Identifies and communicates… more
- Stanford Health Care (Palo Alto, CA)
- …a Stanford Health Care job.** **A Brief Overview** The Senior Value Based Management Specialist works as a key link between the supply chain and clinical teams. This ... used, all while maintaining or improving patient care quality. The specialist collaborates with physicians, clinical staff, and administrative leaders to standardize… more
- University of Southern California (Arcadia, CA)
- …Minimum of three years' experience in clinical disciplines (RN, MD, FMG) or utilization review /case management in an acute care facility, with clinical ... and other clinical staff. + Meets established productivity targets for record review and appropriate query placement. + Demonstrates working knowledge of ICD-10 CM… more
- Kuehne+Nagel (Torrance, CA)
- …counts in more ways than we imagine. **** The Operational Care Specialist is responsible for managing the coordination of shipments accurately and timely, ... meeting customer transit time requirements. The Operational Care Specialist is part of a team (Operational Care Centers)...KN systems, including financial data, such as costs + Review and clarify CCL instructions if there are conflicts… more
- Maersk (Los Angeles, CA)
- Logistics Specialist **Opportunity** As a company, we promote a culture of honesty and integrity, and value the trust it allows us to build with customers and ... excellence that will save time and money. The Control Tower Logistics Specialist will be responsible for providing the proactive feedback and recommendations on… more
- Alameda Health System (San Leandro, CA)
- …specific clinical information for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient and post ... SLH Care Management Specialist + San Leandro, CA + San Leandro...in a health care field or one year in Utilization Management at a Medical Group or Health plan… more
- Oracle (Sacramento, CA)
- …Manager and the roles within the pods (eg, Business Analyst, Integration Specialist , QA, etc.) and contribute to strategic planning, direction, and goal setting ... procedures, contractual budgets, providing expert-level insight on the development, utilization , and revision of contractual agreements. + Maintains customer… more
- Norstella (Sacramento, CA)
- Client Success Renewals Specialist Company: MMIT Location: Remote, United States Date Posted: Dec 22, 2025 Employment Type: Full Time Job ID: R-978 **Description** ... and responsive to patient needs. **The Role:** The Client Success Renewals Specialist works in collaboration with the Client Success Operations Manager and Client… more
- J&J Family of Companies (Santa Barbara, CA)
- …**Job Description:** We are searching for the best talent for Neuroscience Sales Specialist to be in Santa Barbara, CA. **About Neuroscience** Our expertise in ... of the way. Learn more at https://www.jnj.com/innovative-medicine **The Neuroscience Sales Specialist will:** + Drive demand generation of Spravato through clinical… more
- J&J Family of Companies (Santa Barbara, CA)
- …**Job Description:** We are searching for the best talent for Neuroscience Sales Specialist to be in Santa Barbara, CA. **About Neuroscience** Our expertise in ... of the way. Learn more at https://www.jnj.com/innovative-medicine **The Neuroscience Sales Specialist will:** + Drive demand generation of Spravato through clinical… more
- J&J Family of Companies (Irvine, CA)
- …We are searching for the best talent for an Executive Oncology Sales Specialist to cover the Orange County, CA territory. **About Oncology** Our expertise in ... of the way. Learn more at https://www.jnj.com/innovative-medicine The Oncology Specialist (OS) in the CAR-T franchise is a Field...this role, the OS is responsible for driving appropriate utilization of J&J's CAR-T therapy within the account and… more
- Naval Education and Training Command (Port Hueneme, CA)
- Summary You will serve as a INSTRUCTIONAL SYSTEMS SPECIALIST for the Navy Education and Training Command at the CENTER FOR SEABEES AND FACILITIES ENGINEERING. ... and budgetary requirements for products and services. You will review and recommend approval of policies/procedures; curricula; instructional methods/techniques;… more
- Naval Supply Systems Command (CA)
- Summary You will serve as an Inventory Management Specialist in the Material Support Division of the Industrial Support Department of NAVSUP FLC SD GF. ... and anticipated storage requirements and advise supervisors. You will continuously review warehousing activities to ensure processes stay current with required… more
- University of Southern California (Los Angeles, CA)
- …(USC) Procurement Services is seeking a strategic-minded and experienced Procurement Specialist (Central) to join its team . This position manages operational ... providing routine and non-routine services and activities. The Procurement Specialist (Central) is responsible for transactions of varying complexity (eg,… more
- LA Care Health Plan (Los Angeles, CA)
- …by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health ... Care Management Specialist II Job Category: Clinical Department: Care Management...to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform… more
- Fluor (Sacramento, CA)
- …Central Valley. **Job Description** Under the general direction of the Senior Commercial Specialist , the Procurement Specialist functions as a team member who is ... Office, Contract Management Branch. Core Duties: * Applies knowledge and utilization of both efficient procurement processes, market research, and good business… more