- TEKsystems (Canoga Park, 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
- 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
- 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
- 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
- University of Southern California (Los Angeles, CA)
- The Quality Regulatory Specialist is responsible for leading system-wide activities to evaluate and improve adherence to accreditation standards as well as state and ... for the leadership team including but not all inclusive: KPI, Utilization , Patient satisfaction, After hours care. Prepares reports for leadership presentations.… more
- TriMas Corporation (Commerce, CA)
- …of operations for tools & dies where final results have minimal or no review by others. Measures, marks and scribes metal stock for machining. Determines critical ... Impact on production is substantial either to productivity or machine/equipment utilization . Possible significant damage of tools, accessories, to machines, etc. may… more
- Novo Nordisk (Santa Monica, CA)
- …appropriate patients that would benefit in order to ensure early trial and utilization + Generates advocacy for Novo Nordisk products and services by sharing ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications + Bachelor's or equivalent degree, and/or… more
- LA Care Health Plan (Los Angeles, CA)
- …achieve that purpose. Job Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative and ... Authorization Technician II (ALD) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and to ensure… more
- LA Care Health Plan (Los Angeles, CA)
- …and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The ... include inpatient, outpatient, and professional claims. Serves cross functionally with Utilization Management, Medical Directors, and other internal teams to assist… more
- The County of Los Angeles (Los Angeles, CA)
- …and implements the recreation therapy programs through effective and efficient utilization of subordinate staff, recreation facilities and equipment and supplies. + ... Certification -OR- Current certification to practice as a Therapeutic Recreation Specialist issued by the National Council for Therapeutic Recreation Certification.… more
- Clean Harbors (Compton, CA)
- …to include but not limited to improving operational efficiencies through effective utilization of equipment and scheduling of personnel. Interact with Sales Team and ... and all applicable discrepancies. * Performs revenue forecasting. * QA/QC's all specialist work. * Oversees customer service responsibilities for office. * Enforces… more
- University of Southern California (Los Angeles, CA)
- …and preventive maintenance procedures + Provide input to annual Performance Appraisal review for staff rotating in section. Assists in the process of commendations, ... and continuing education of staff. + Monitor space/resource requirements and utilization of outside resources. + Assures results are available within defined… more
- University of Southern California (Los Angeles, CA)
- …and preventive maintenance procedures + Provide input to annual Performance Appraisal review for staff rotating in section. Assists in the process of commendations, ... and continuing education of staff. + Monitor space/resource requirements and utilization of outside resources. + Assures results are available within defined… more
- Citigroup (Los Angeles, CA)
- …the appropriate partners as necessary (eg leverage video conference for FA, mortgage specialist , etc.) + Take full ownership of clients' problems to resolve client ... digital first approach, focus on client problem resolution and effective utilization digital technologies + Resolving complex client issues or needs; connect… more