- 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
- 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 ... are adequately identified, fully justified and properly approved. May lead credit review examinations, prepare final reports, and conduct overall meetings with Bank… more
- Robert Half Legal (Oakland, CA)
- Description We are seeking a California-barred Document Review Attorney for a fully remote opportunity supporting litigation and compliance projects. This role is ... East Bay area for occasional in-person meetings or onboarding. Responsibilities + Review and analyze large volumes of documents for relevance, privilege, and… 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
- 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
- Deloitte (Los Angeles, CA)
- …facts patterns and laws, regulations, cases and administrative guidance. + Comprehensive review of information to understand a Client's business and its tax returns. ... up of multiple tax service offerings including Strategic Tax Review , Inventory Tax Services, and Meals & Entertainment ...Review , Inventory Tax Services, and Meals & Entertainment Review Services, among others. Each NFTS service offering has… more
- Molina Healthcare (San Diego, CA)
- …JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant education… more
- Molina Healthcare (San Diego, CA)
- California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_3-12 NIGHT SHIFT 7:30PM - 08:30AM PACIFIC HOURS NON EXEMPT, 3 days a week will ... **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… 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 ... position may be assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review . Responsibilities may include: - Conducts… more
- Molina Healthcare (Long Beach, CA)
- …JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... health care experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
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