- Cedars-Sinai (Los Angeles, CA)
- …OR CPC, required Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge ... World Report has named us one of America's Best Hospitals. As our next Clinical Documentation Specialist, you will work under the general direction of the HID… more
- Molina Healthcare (Long Beach, CA)
- …work Pacific business hours.** JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying ... that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes… more
- Molina Healthcare (San Diego, CA)
- …work Pacific Business Hours.** JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying ... that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes… more
- Molina Healthcare (San Diego, CA)
- …hours as posted._** **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying ... California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_3-12 NIGHT SHIFT 7:30PM - 08:30AM PACIFIC HOURS NON EXEMPT, 3 days a week will… more
- Molina Healthcare (CA)
- …work Pacific business hours.** JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying ... that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes… more
- Providence (Mission Hills, CA)
- …prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission ... **Description** **RN Utilization Review at Providence Holy Cross Medical Center in...by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in… more
- CenterWell (San Diego, CA)
- …policies and standards. + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by ... caring community and help us put health first** The Clinical Manager coordinates and oversees all direct care patient...Utilization Review staff. Upon completion of the assessment, creates and… more
- Parexel (Sacramento, CA)
- … Clinical Quality Monitoring of critical data. Support close to real time clinical data Ongoing medical review with transparent documentation of the activity, ... Plan (TSAP) etc Medical contribution to Patient Narrative preparation, Clinical Trial Report planning and review of...Narrative preparation, Clinical Trial Report planning and review of medical sections of Clinical Trial… more
- Bristol Myers Squibb (Brisbane, CA)
- …assessments. This role includes support of cross-portfolio activities in line with Clinical Excellence, including Protocol Review Committee, support of Business ... * The role includes support of across portfolio activities in line with Clinical Excellence, including eg Protocol Review Committee, support of Business… more
- IQVIA (Carlsbad, CA)
- …based on their experience and training. * Manage the quality of assigned staff's clinical work through regular review and evaluation of work product. * ... Job Overview Manage a team of clinical staff working in support of clinical...review and reporting of findings as outlined by clinical operations management. * May collaborate with other … more