- Gilead Sciences, Inc. (Foster City, CA)
- …company that discovers, develops and commercializes innovative medicines in areas of unmet medical need. We strive to transform and simplify care for people with ... centric, science focused company. Reporting to the Executive Director of Global Medical Affairs Technology, this individual will be responsible for driving delivery… more
- Prime Healthcare (Inglewood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/231150/ medical - review -coordinator/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Overview At Centinela Hospital Medical Center, our dedicated team of professionals are...open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/232555/ medical - review -coordinator/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... members to join our corporate team! Responsibilities Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case Management… more
- TEKsystems (Canoga Park, CA)
- …+ Perform comprehensive utilization reviews for inpatient and outpatient claims. + Prepare medical records for review by medical directors and provide ... active license to join our team as a Utilization Review Nurse. In this role, you will conduct retrospective...retrospective reviews of inpatient and outpatient claims to ensure medical necessity, compliance, and timely processing within a managed… more
- Emanate Health (Covina, CA)
- …and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and… more
- Providence (Mission Hills, CA)
- …and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required ... **Description** **RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part- time and will work 8-hour, Day… more
- BeOne Medicines (San Mateo, CA)
- …data & drafts response and manages approval of responses + Guides and leads medical review of SAEs and provides immediate input to escalated reports, determines ... input to CRFs + Leads the formulation safety criteria and review of study specific medical monitoring plans + Participates in investigator meetings, as needed,… more
- UCLA Health (Los Angeles, CA)
- …including inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan ... and safety. In this role, you will supports all Medical Group Health Education & Disease Management Programs utilizing...travel to various clinic sites and schedule and conduct medical record and facility site audits + Conduct thorough… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …teams + Utilize platforms like Veeva Vault, to manage content lifecycle and Medical Review submissions. + Track and report content usage and effectiveness, ... regional and affiliate medical teams. + Serve as a champion for Medical Review / Promotional review processes for materials + Manage content lifecycle… more
- Travelers Insurance Company (Sacramento, CA)
- …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical review policies. Works in close collaboration with the Claim leaders and in partnership with other … more
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