- University of Southern California (Los Angeles, CA)
- …and member claims and plan related issues. . Plans and conducts quality assurance reviews and recommends changes as appropriate. Develops and maintains ... identifies trends and needs and establishes program directions accordingly. Assesses quality of program operations. Modifies existing program services or creates new… more
- LA Care Health Plan (Los Angeles, CA)
- …Managed Risk Medical Insurance Board (MBMIB) and National Committee for Quality Assurance (NCQA) regulatory requirements. This position reviews pre-service ... complaint and appeals issues, including eligibility, access to care, claims , benefit, and quality of care concerns. Experience working with firm deadlines, able… more
- Sedgwick (Sacramento, CA)
- …of a client Disability Pension Board + Review of identified appeal cases for quality assurance purposes + Voting member to determine if eligibility requirements ... regulations, and client service requirements and assure efficient, cost effective, quality program delivery for medical and disability management. + Coordinating and… more
- Astrix Technology (Rancho Dominguez, CA)
- …foster a culture dedicated to product consistency and customer satisfaction._ The ** Quality Assurance Documentation Specialist** is responsible for ensuring that ... + Ensure that all forms generated by the Production, Quality Assurance , and Sanitation departments adhere to...including FDA, COOL, Prop 65, Nutritional Warnings, and Health Claims + Experience with NLEA labeling guidelines and the… more
- LA Care Health Plan (Los Angeles, CA)
- …Support and Control will report to Director, Production Support within the IT Quality Assurance and Process excellence organization and will be primarily ... services. Collaborate with Infrastructure team, hosted vendor teams, Release Management and Quality Assurance teams to address production incidents per the… more
- Humana (Sacramento, CA)
- …Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance , and compliance + Determining root causes driving issues ... IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families,… more
- Centene Corporation (Sacramento, CA)
- …activities. + Performs medical review activities pertaining to utilization review, quality assurance , and medical review of complex, controversial, or ... to providers that would improve utilization and health care quality . + Reviews claims involving complex, controversial, or unusual or new services in… more
- Sedgwick (Sacramento, CA)
- …completed documentation from providers to ensure accuracy, completeness, adherence to quality assurance standards. + Determine the outcome of involvement ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Element Consulting (Los Angeles, CA)
- …execution philosophies * Perform contractor schedule reviews for contract conformance and quality assurance * Evaluate contract change orders and amendments for ... and scheduling. * Experience with time impact analysis. * Experience with construction claims and change orders. * Flexibility in schedule and transportation to work… more
- Harris & Associates (Monterey Park, CA)
- …execution philosophies + Perform contractor schedule reviews for contract conformance and quality assurance + Evaluate contract change orders and amendments for ... time impact analysis of project schedule delays and potential claims + Participate in change order negotiations + Perform...Experience with time impact analysis. + Experience with construction claims and change orders About Us Harris & Associates… more