• Medical Claims Examiner (Remote…

    TEKsystems (Fresno, CA)
    We are hiring Medical Claims Examiners! Must live within 65 miles of Fresno, CA to be considered due to onsite training requirements. Location: Fully remote with ... 4:00PM PST Monday-Friday Overview Our client is seeking a Medical Claims Examiner to join their growing... processing, attention to detail, and a commitment to quality assurance . The position involves adjudicating a… more
    TEKsystems (09/03/25)
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  • Risk Management Manager - Quality

    Prime Healthcare (Chino, CA)
    …Us! (https://careers-primehealthcare.icims.com/jobs/222648/risk-management-manager quality - assurance /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Chino Valley Medical Center has been recognized nationally for its quality , including as among the 100 Great Community Hospitals by Becker's Hospital Review… more
    Prime Healthcare (08/26/25)
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  • Risk Management Coordinator - Quality

    Prime Healthcare (Redding, CA)
    …Us! (https://careers-primehealthcare.icims.com/jobs/218087/risk-management-coordinator quality - assurance /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... an award-winning team of dedicated professionals committed to our core values of quality , compassion and community! Shasta Regional Medical Center, a member of… more
    Prime Healthcare (08/27/25)
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  • Sr. Manager, Major Claims Unit

    ICW Group (Pleasanton, CA)
    …support appropriate financial forecasting, reinsurance reporting and risk scoring. + Oversees quality assurance processes and conducts regular audits of complex ... in-house counsel for litigation strategy and nurse case managers for medical management. **ESSENTIAL DUTIES AND RESPONSIBILITIES** **Strategic Claims more
    ICW Group (08/27/25)
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  • RN - Quality Assurance /Utilization…

    Emanate Health (Covina, CA)
    …indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and ... in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying clinical acumen and… more
    Emanate Health (09/06/25)
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  • Claims Examiner

    TEKsystems (Los Angeles, CA)
    Medical Claims Examiner Location: Remote (must be located in Santa Barbara or Los Angeles) Department: Claims Processing Job Summary: We are seeking a ... detail-oriented Claims Examiner to join our team. This role is...departmental improvement projects. + Perform audits and contribute to quality assurance efforts. Qualifications: + Prior experience… more
    TEKsystems (09/03/25)
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  • Sr. Quality Engineer

    Envista Holdings Corporation (Pomona, CA)
    …The **Sr. Quality Engineer** plans and conducts activities concerned with the quality assurance of industrial processes, materials, and products. The Sr. ... working closely with cross-functional teams to develop, implement, and maintain quality assurance protocols that comply with regulatory requirements and… more
    Envista Holdings Corporation (06/13/25)
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  • Executive Director of R&D Global Quality

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...years of experience in a FDA regulated pharmaceutical and/or medical device industry environment + Strong knowledge of current… more
    Otsuka America Pharmaceutical Inc. (08/14/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (CA)
    …documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. ... different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of acute care… more
    Banner Health (09/06/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …clinical ackground and skills. + Solid understanding of utilization management and quality assurance activities. + Excellent communication skills, both verbal ... + Provides professional leadership and direction to the functions within the Medical Management Department (Utilization/Cost Management and Quality Management) +… more
    Sharp HealthCare (07/19/25)
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