- PennyMac (Moorpark, CA)
- …mortgage journey. A Typical Day Position Summary:The Operations Manager - Precision Review at PennyMac will lead and oversee a specialized team responsible for ... improvement, and team development, driving efficiency and accuracy across the Precision Review function. The Operations Manager will serve as a key partner to… more
- City National Bank (Los Angeles, CA)
- *SENIOR CREDIT RISK REVIEW OFFICER* WHAT IS THE OPPORTUNITY? The Credit Risk Review Department (CRR), is part of the 3rd line of defense, and as such is ... risk and the administration of Bank credit/loan exposure; analyzes and monitors the quality of various retail and commercial credits that represent the wide range of… more
- Centene Corporation (Sacramento, CA)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high- quality , evidence-based care. This ... related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established guidelines to… more
- Dignity Health (Rancho Cordova, CA)
- …from home** **within driving distance of Sacramento, CA** **.** As a Utilization Review (UR) LVN, you will use clinical judgement in providing utilization management ... (UM) services. The focus is to provide high quality , cost-effective care which will enable patients to achieve...assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review . Responsibilities may… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong knowledge of claims ... contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer support duties that require… more
- Prime Healthcare (Lynwood, CA)
- …and 300,000 children in our community who count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of ... Join an award-winning team of dedicated professionals committed to compassion, quality , and service! Responsibilities Responsible for the quality and… more
- Ankura (Los Angeles, CA)
- …and other analytical tools. + Supervise and conduct data gathering activities, document review , and quality control of data assessment. + Prepare client ... he/she would perform the following types of activities: + Direct and review the development of complex analytical models leveraging relational database software,… more
- Ankura (Los Angeles, CA)
- …and other analytical tools. + Supervise and conduct data gathering activities, document review , and quality control of data assessment. + Apply innovative ... perform the following types of activities: + Direct and review the development of complex analytical models leveraging relational...Ability to manage multiple concurrent projects. + Commitment to quality and working within a team. + Effective oral… more
- Ankura (Los Angeles, CA)
- …investigation projects for clients. + Oversee and conduct data gathering activities, document review , and quality control of data assessment. + Work with Senior ... + Prepare client communications, both written and oral, for senior level review . + Perform client facing tasks including operational, compliance or regulatory… more