• RN Supervisor UM Prior Auth

    Dignity Health (Rancho Cordova, CA)
    …working knowledge of Utilization Management Working knowledge of the Utilization Management review processes, and regulatory requirements. Must have the ability ... requests are processed in a consistent and timely manner while observing regulatory guidelines. Responsibilities may include: - Responsible for day to day operations… more
    Dignity Health (08/18/25)
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  • Medical Director, Late Development, Oncology

    Pfizer (South San Francisco, CA)
    …or other value received, generally for public disclosure. Subject to further legal review and statutory or regulatory clarification, which Pfizer intends to ... + Conduct medical monitoring activities including eligibility assessment, data review and safety monitoring. + Lead peer-to-peer interactions with investigator.… more
    Pfizer (08/09/25)
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  • Senior Medical Director, Late Development,…

    Pfizer (South San Francisco, CA)
    …or other value received, generally for public disclosure. Subject to further legal review and statutory or regulatory clarification, which Pfizer intends to ... + Conduct medical monitoring activities including eligibility assessment, data review and safety monitoring. + Lead peer-to-peer interactions with investigator.… more
    Pfizer (08/09/25)
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  • Senior Commercial Review Appraiser

    UMB Bank (Sacramento, CA)
    …under normal and stressed scenarios. Within Credit Administration, the **Appraisal Review ** team supports Commercial, Small Business and Consumer Lending. As a ... Senior Commercial Review Appraiser, you will ensure compliance with the valuation...+ Demonstrated ability to effectively apply bank policy and regulatory requirements to daily responsibilities. **Compensation Range:** $83,200.00 -… more
    UMB Bank (08/13/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Sacramento, CA)
    …reviews related to BH to determine medical appropriateness in accordance with ABA regulatory guidelines and criteria + Analyzes BH member data to improve quality and ... health clinicians preferred. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans required. Knowledge of ABA services… more
    Centene Corporation (08/09/25)
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  • Quality Management Clinical Nurse - Facility Site…

    UCLA Health (Los Angeles, CA)
    …inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan and/or ... regulatory audits for medical appropriateness by using established clinical...training to internal staff on quality management practices and regulatory requirements + Assist in QM Department projects including… more
    UCLA Health (07/14/25)
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  • Physician Advisor, Utilization Review

    Sutter Health (Sacramento, CA)
    …are in the appropriate level of care with supporting documentation of regulatory compliance and accurate coding. The Physician Advisor (PA) conducts clinical reviews ... referred by UM/CM staff and or other healthcare professionals to meet regulatory requirements in accordance with the hospital objectives for assuring quality patient… more
    Sutter Health (06/12/25)
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  • Quality Review Nurse

    Sedgwick (Sacramento, CA)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague technical and ... uphold quality initiatives ensuring that the clinical work product meets regulatory , jurisdictional, case management and company Best Practice requirements. **ARE… more
    Sedgwick (08/15/25)
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  • Senior Estimate Review Specialist

    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 ... using various estimating applications; to ensure estimates follow client and regulatory requirements and meet Property guidelines; to serve as a subject… more
    Sedgwick (06/29/25)
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  • Quality Assurance Specialist I - Therapeutics

    LGC Group (Petaluma, CA)
    …manufacturing batch records for completeness and compliance with cGMPs as per regulatory requirements and internal procedures. Review batch records, summary ... + Quality & Compliance: Complete all activities adhering strictly to quality and regulatory standards and procedures. Foster a focus on quality and strive for… more
    LGC Group (08/04/25)
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