• Surgical Clinical Reviewer (On-Site)

    UCLA Health (Santa Monica, CA)
    …community clinics throughout Southern California. We're also home to the world-class medical research and clinical education capabilities of the David Geffen School ... of Medicine. Through the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health. UCLA… more
    UCLA Health (10/09/24)
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  • Facility Site Review Nurse Specialist RN II

    LA Care Health Plan (Los Angeles, CA)
    …Site Review (FSR) Nurse Specialist RN II conducts Full Scope Reviews, Site Review Surveys, Medical Record Review Surveys, Specialty Site Review ... Facility Site Review Nurse Specialist RN II Job Category: Clinical...and maintain successful completion of a DHCS Certified Site Reviewer certification in order to conduct DHCS accepted audits… more
    LA Care Health Plan (09/20/24)
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  • Appraisal and Valuation Services, Vice President

    MUFG (Los Angeles, CA)
    …3) as a participant in syndication deals. Therefore, there will be times when the reviewer will be required to review , and possibly correct, an appraisal not ... either the original appraiser or are corrected by the review appraiser. MUFG Bank may act, 1) as sole...ordered by MUFG Bank. The reviewer may not be able to discuss the appraisal… more
    MUFG (10/17/24)
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  • Utilization Review Nurse Supervisor II

    The County of Los Angeles (Los Angeles, CA)
    …direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of ... of procedures for and the effective conduct of the system to review patients' medical charts to ascertain the medical necessity for services and… more
    The County of Los Angeles (09/30/24)
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  • SVP, Credit Review Director

    Banc of California (Santa Ana, CA)
    …and more. TOGETHER WE WIN(R) **THE OPPORTUNITY** The Senior Vice President, Credit Review Director is responsible for leading the independent Credit Review ... The Credit Review Director ensures the team's compliance with the Credit Review Policy, executing the annual Credit Review Plan, and managing internal staff… more
    Banc of California (10/11/24)
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  • VP, Senior Credit Review Examiner

    Banc of California (Santa Ana, CA)
    …global cash flow and repayment sources that help define asset quality. Ensure Credit Review risk rating changes have been updated on the loan system of record timely ... as well as findings based on process weaknesses and systemic issues. Will review , document, and track corrective action to ensure timely remediation. + Will act… more
    Banc of California (10/11/24)
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  • Bill Review Trainer - Hearing Specialist

    Sedgwick (Los Angeles, CA)
    …on behalf of the Lien Resolution Unit + Handle all aspects of research, file review , and negotiation of outstanding medical lien + Prepare lien settlements + ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Bill Review Trainer - Hearing Specialist **PRIMARY PURPOSE** : To develop and conduct… more
    Sedgwick (10/21/24)
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  • Inpatient Review (RN) Case Manager : Night…

    Molina Healthcare (Long Beach, CA)
    **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_PERMANENT SHIFT WILL BE :_** **_12 hour NIGHT SHIFT: 7:30PM (in the evening) - 08:30AM (in the morning) PACIFIC HOURS ... then on._** **_Previous experience with Emergency Room Utilization Management / Utilization Review is preferred for this role. Experience with Case Management is a… more
    Molina Healthcare (09/26/24)
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  • Utilization Management Denial Review Nurse…

    UCLA Health (Los Angeles, CA)
    …UCLA Health. You will play a key part in promoting high-quality, cost-effective medical care by applying clinical acumen and applicable policies and guidelines in ... the issuance of adverse organization determinations. You will review for appropriate care and setting while working closely with denial coordinators and other staff… more
    UCLA Health (09/24/24)
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  • Utilization Management & Quality Review

    UCLA Health (Los Angeles, CA)
    …clear, timely communication is provided to all stakeholders. + Working closely with medical director, utilization management and quality review team to ensure ... Description As the Utilization Management & Quality Review Specialist, you will be responsible for: + Managing service requests and potential quality issue cases,… more
    UCLA Health (10/31/24)
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  • Care Review Processor (PST)

    Molina Healthcare (Los Angeles, CA)
    …+ Provides telephone, clerical, and data entry support for the Care Review team. + Provides computer entries of authorization request/provider inquiries, such as ... authorization requests or for additional information as requested by the Medical Director. **Job Qualifications** **Required Education** HS Diploma or GED **Required… more
    Molina Healthcare (10/17/24)
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  • Principal Senior Health Scientist

    Stantec (Irvine, CA)
    …+ Works under minimal supervision with broad guidelines to assign, review , and evaluate the performance of new project orders, directing interdisciplinary ... relatively large teams of diverse disciplines + Serves as a senior reviewer and/or Principal-In-Charge of projects, research efforts, and manuscripts + Generates… more
    Stantec (08/08/24)
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  • Discharge Planner I

    Prime Healthcare (Inglewood, CA)
    Overview At Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a ... Prime Healthcare, a Top-15 hospital system in the United States, Centinela Hospital Medical Center is actively seeking new members to join its award-winning team!… more
    Prime Healthcare (11/02/24)
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  • Discharge Planner II - Licensed Vocational Nurse,…

    Prime Healthcare (Inglewood, CA)
    Overview At Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a ... Prime Healthcare, a Top-15 hospital system in the United States, Centinela Hospital Medical Center is actively seeking new members to join its award-winning team!… more
    Prime Healthcare (11/02/24)
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  • Project Manager, Electrical Engineering

    Stantec (Los Angeles, CA)
    …required for electrical engineering projects. + May periodically act as QC reviewer on projects. + Effectively delegates work to production support staff. + ... as they specifically apply to Hospitals, ambulatory surgical centers, and medical office buildings. + Familiarity with, and ability to produce, project-related… more
    Stantec (10/05/24)
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  • LVN Discharge Planner

    Prime Healthcare (La Palma, CA)
    …and authorizations. Maintains and coordinates Medi-Cal (TARS) for presentation to on-site reviewer and files them accordingly or as per facility's procedure. Assists ... but is not limited to, paid time off, a 401K retirement plan, medical , dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.… more
    Prime Healthcare (10/01/24)
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  • Discharge Planner - LVN Case Management

    Prime Healthcare (Inglewood, CA)
    …maintain and coordinate Medicaid state submission forms for presentation to on-site reviewer and files them accordingly or as per facility's procedure. Assists with ... but is not limited to, paid time off, a 401K retirement plan, medical , dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.… more
    Prime Healthcare (10/29/24)
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  • Principal - Mission Critical

    Stantec (Los Angeles, CA)
    …and calculations required for engineering projects. + Act as a QC reviewer on Electrical Engineering projects. Technical Leadership - approximately 10% of time ... **Benefits Summary:** Regular full-time and part-time employees have access to medical , dental, and vision plans, a wellness program, health saving accounts,… more
    Stantec (10/26/24)
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  • Senior Technical Lead/Project Manager - CCR…

    AECOM (Los Angeles, CA)
    …activities. + Mentor and coach team members as required + Serve as a reviewer + Local and national travel (up to 20% of the time). **Qualifications** **Required ... of our employees. Depending on your employment status, AECOM benefits may include medical , dental, vision, life, AD&D, disability benefits, paid time off, leaves of… more
    AECOM (09/27/24)
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