- Sharp HealthCare (San Diego, CA)
- …of Authorization Review for Sharp Health Plan (SHP). The Physician Reviewer will perform all reasonably necessary functions to ensure quality of care and ... care physician with knowledge of managed care and the process for prior authorization review . + California Physicians and Surgeons License - Medical Board of CA -… more
- ThermoFisher Scientific (Foster City, CA)
- **Work Schedule** Standard (Mon-Fri) **Environmental Conditions** Office **Job Description** Role: QC Reviewer This is a fully onsite role based at our customer's ... in: Foster City, CA Essential Functions: Performs complex analytical data review , evaluating laboratory data for compliance with analytical methods, SOPs, directives… more
- Essel (Sacramento, CA)
- …of Unearth, utility inspections, mapping, or CAD-based roles is a plus. Requirements Video Review and Analysis: + Review hours of crossbore inspection videos for ... quality, clarity, and completeness. + Document critical data, including pipe lengths, locations, and inspection notes, using specialized software. + Identify unclear or incomplete videos and coordinate re-inspections with field teams. + Managing data, maintain… more
- Evolent (Sacramento, CA)
- …with the Director of UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory of the United States. Acts ... with honor and integrity, serving as a role model for the company. Performs other duties as assigned. **QUALIFICATION REQUIREMENTS** : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements… more
- TEKsystems (Redding, CA)
- …+ Investigate returned checks-connect with clients and resolve address issues. + Keep records organized-log invoices, scan checks, and maintain digital files. + ... Prepare deposit reports-communicate with accounting and ensure documentation is complete. + Safeguard financial documents-follow strict confidentiality and compliance protocols. What You Bring + Analytical mindset-solve problems and think critically. +… more
- CVS Health (Sacramento, CA)
- …extraction and analysis, dedicated to a specific self-funded plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse ... analyze and document analytic leads or referrals to send for investigative review . + Review company clinical and payment policies to determine the impact of the… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working in… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the largest… more
- Prime Healthcare (Ontario, CA)
- …actively seeking new members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization review and ... appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry, mailing/faxing appeals… more
- CBRE (Sacramento, CA)
- VAS - First Vice President, Appraisal Review Job ID 248636 Posted 19-Nov-2025 Service line Advisory Segment Role type Full-time Areas of Interest ... Role:** As a CBRE VAS First Vice President (Appraisal Review ), you will work directly with the leadership team...appraisers to manage risk and participate in the valuation review process. **What You'll Do:** + Follow the set… more