- City and County of San Francisco (San Francisco, CA)
- …in partnership with the US Army Corps of Engineers (USACE). Released for public review in 2024, the Flood Study includes a $13.5 billion Draft Plan that outlines ... to mid-2028) include the Living Seawall Pilot, permitting and environmental review , community engagement, design and engineering, and alignment with local, state,… more
- UCLA Health (Los Angeles, CA)
- …the ICM Medicare Advantage Utilization Review Nurse performs utilization review of medical necessity and appropriateness, cost containment and efficiency, ... quality reporting for referrals for Medicare Advantage population enrolled under UCLA Medical Group. The ICM Medicare Advantage Utilization Review Nurse ensures… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and… more
- Sedgwick (San Francisco, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Estimate Review Specialist **PRIMARY PURPOSE** **:** To review all estimates and ... reviews, and sends fair and accurate estimates through various platforms. + Records data around initial estimates reviewed, number of reviews, and rejections on… more
- Harris & Associates (Irvine, CA)
- …Senior Project Manager to help lead, market and expand our Cost Reimbursement Review team. The ideal candidate will have strong project management skills, experience ... project schedules, and monitoring project budgets. + Leads cost reimbursement review projects including change order reviews, preparation of cost estimates, and… more
- Centene Corporation (Sacramento, CA)
- …referrals in accordance with policies and guidelines + Supports the authorization review process by researching and documenting necessary medical information ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Prime Healthcare (Ontario, CA)
- …achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive review of the medical record for the medical ... + At least 3 years of experience in utilization review , referrals, authorizations, denials and appeals. + Current BCLS...limited to, paid time off, a 401K retirement plan, medical , dental, and vision coverage, tuition reimbursement, and many… more
- US Bank (Irvine, CA)
- …and appraisals for complex commercial real estate property types and transactions. Review appraisal reports for compliance with bank policy and procedures, USPAP, ... policy and procedures and state and federal appraisal regulations. Maintain review productivity and quality control measurements in-line with department benchmarks.… more
- The County of Los Angeles (Los Angeles, CA)
- …(CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty and subspecialty. In ... its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the County's 911 emergency...of subordinate supervisory staff and serves as first level reviewer of all performance evaluations. + Resolves or consults… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- …ability to interpret provider prescription and referral. Reviews and screens patient's medical record for appropriateness of PT/OT/ST intervention, noting any ... Complexity 1A facility, the UR Physical Therapist serves as the clinical utilization reviewer (UR) for rehabilitation services in the Office of Community Care (OCC).… more