Utilization review jobs in Los Angeles, CA - Page 4Create job alerts

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating...

Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. Assist the Chief Medical Director to direct and coordinate the medical management, q...

Perform clinical site reviews and/or medical record reviews as directed in support of health plan and/or other regulatory/accreditation/compliance requirements •Perform chart abstraction and analysis of root causes, presentation of cases for review with physician panel, discussion of opportuni

Seeking an experienced Registered Nurse (RN) Care Coordinator for a 13-week contract assignment in the Case Management/Utilization Review department. Unit Type: Care Coordinator - Case Management / Utilization Review. Collaborate with the interdisciplinary healthcare team to manage transitions of...

Conducting utilization management (UM) activities in accordance with health plan policies and regulatory guidelines. Two or more years of experience in utilization management, preferably in Medicare Advantage or managed care. Proficiency in electronic health records (EHR) and utilization manageme...

Utilization Review or Concurrent Review. RN - Utilization Review or Concurrent Review. Genie Healthcare is looking for a RN to work in Utilization Review or Concurrent Review for a 13 weeks travel assignment located in Los Angeles, CA for the Shift (5x8 Days - Please verify shift details with rec...

The Associate Administrator of Clinical Throughput Operations provides strategic direction, leadership, planning, and organizational management for the outside hospital transfers, Transfer Center operations, and Care Coordination operations (including Case Management, Social Work, Utilization Rev...

Under minimal supervisory, the Transfusion Medicine Quality Coordinator will be responsible for the assessment of quality systems within blood bank. Prepare documents and reports as necessary for quality oversight committees (Blood Utilization Review, Laboratory Quality Assessment and others that...

The Manager of Utilization Review provides direct supervision to the Utilization Review Specialists, Utilization Management Specialists, Authorization Coordinators, and ancillary staff. The Manager is accountable for daily department operations, including establishing utilization review processes...

Direct past experience with Health Care / Medical Policy work specifically within a Managed Care Plans environment; experience with the ongoing development of the Medical Policy review process including clinical and utilization data analysis; Assisted in developing training documents and presenta...

Supervise Occupational Therapy Assistants in direct patient care and patient related activities, following state practice act. Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Record evaluations, daily treatment notes, weekly progress ...

Attends Utilization Review Committee meetings to inform the committee of new or revised utilization review requirements, the impact of the requirements, and procedures to be implemented for compliance, as needed. Reviews, retrospectively, utilization review records for completeness, use of approp...

Supervise Speech Language Pathologist Assistants in direct patient care and patient related activities, following state practice act. Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Record evaluations, daily treatment notes, weekly pr...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge...

IDR Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California.Job Description & Requirements.IDR Healthcare is an awarding winning staffing firm that believes it is a privilege and awesome responsibility to serve those who selflessly care for othe...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge ...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Oncology, recognized by the American Board of Medical Specialties (ABMS), with recent practice ...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge...

Genie Healthcare is seeking a travel nurse RN Utilization Review for a travel nursing job in Los Angeles, California. Genie Healthcare is one of the fastest growing Nurse Travel Agencies in the USA.

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge ...

IDR Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California.Job Description & Requirements.IDR Healthcare is an awarding winning staffing firm that believes it is a privilege and awesome responsibility to serve those who selflessly care for othe...

Why You Will Love Working With Us! At Clearview Outpatient, we are a dynamic, dedicated, and growing team of professionals deeply passionate about providing evidence-based and personalized clinical care for behavioral health conditions. Our team’s foundation is client-centered care and clin...

Job Description Position Purpose: The Registration Clerk serves as the first point of contact for individuals accessing services through the Harm Reduction Program. This role is vital in ensuring a welcoming, radically hospitable, and trauma-informed environment for clients experiencing homelessn...

Job Description Position Title: Program Operations Supervisor I, II or III Department: Reports To: Program Director POSITION SUMMARY Responsible for overall day-to-day supervision of assigned staff and the shift-to-shift or day to day operations of program or unit. This includes oversight...

Job DescriptionSalary: $22.50 Position Title: Front Office Assistant Department: Front Office Position Reports to: Clinic Office Manager Status: Union Position Summary: Position requires excellent customer service skills with patients, employees, and the public, including but not limiti...

Job DescriptionSalary: $22.50 Position Title: Front Office Assistant Department: Front Office Position Reports to: Clinic Office Manager Status: Union Position Summary: Position requires excellent customer service skills with patients, employees, and the public, including but not limiti...

Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Instruct patient's families or nursing staff in maintenance program and caregiver training in preparation for discharge from therapy services. Participate in in services training program...

Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Instruct patient's families or nursing staff in maintenance program and caregiver training in preparation for discharge from therapy services. Supervise Physical Therapy Assistants in di...

The Travel Nurse RN - Case Manager, Utilization Review role involves providing expert case management and utilization review services as part of a travel nursing assignment in Los Angeles, California. Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nur...

What do we do? Medical Solutions is one of the nation’s largest providers of total workforce solutions in the healthcare industry, connecting nurses and allied health clinicians with hospitals and healthcare systems across the country and around the corner. Travel Nurse RN - Case Manager, Utiliza...

Posted job title: Case Management (Utilization Review). Travel Nurse, Utilization Review, Case Manager, Healthcare Jobs, Travel Nursing, RN Jobs, Nursing Benefits, Medical Solutions, Health Insurance, Flexible Nursing Jobs. Travel Nurse RN - Case Manager, Utilization Review - $2,358 per week at M...

Job Description Position Title: Program Operations Supervisor I, II or III Department: Program Development/Mobile Narcotic Treatment Program Reports To: Program Director POSITION SUMMARY Join a dedicated team of substance use disorder treatment professionals! Seeking a full-time Program O...

Job DescriptionSalary: $126,000.00 - $132,000.00 annually Every day at CMTS, we undertake impactful infrastructure projects that positively impact lives and communities. CMTS has an extensive 40-year industry experience, which ensures a strong foundation for ongoing success. Our company values e...

Job DescriptionOur client is consistently recognized as a best workplace, and for commitment to safety, sustainability, and community partnerships. They hire the very best in the construction industry and strives to create an environment that encourages innovation, responsibility, and client sati...

Job Description Who We Are HMC Architects is an employee-owned design firm with a desire to make a difference in our communities. As a purpose-driven firm based on values, our mission to design for good drives everything we do. And our ownership culture creates alignment and increased commitment...

Job DescriptionOur client is consistently recognized as a best workplace, and for commitment to safety, sustainability, and community partnerships. They hire the very best in the construction industry and strives to create an environment that encourages innovation, responsibility, and client sati...

Job DescriptionSalary: $150,000 -$157,000/yr. Every day at CMTS, we undertake impactful infrastructure projects that positively impact lives and communities. CMTS has 40-years of extensive industry experience, which ensures a strong foundation for ongoing success. Our company values employees by...

Job DescriptionOur client is consistently recognized as a best workplace, and for commitment to safety, sustainability, and community partnerships. They hire the very best in the construction industry and strives to create an environment that encourages innovation, responsibility, and client sati...

Job DescriptionOur client is consistently recognized as a best workplace, and for commitment to safety, sustainability, and community partnerships. They hire the very best in the construction industry and strives to create an environment that encourages innovation, responsibility, and client sati...

Job DescriptionSalary: $130,000-$160,000 Company Overview Frank & Eileen was born in 2009 when former engineer Audrey McLoghlin sought to reinvent the button-up for women a category previously focused solely on men. Inspired by Audreys Irish grandparentsour brand namesakes, Frank & Eileenwe have...

Job Description LA (Lindeman & Associates) launched in 2015 and quickly established itself as a leader in the entertainment advertising space, winning Clio’s Agency of the Year in 2017. LA brings together artists, editors, and storytellers into one hyper-collaborative team specializing in craftin...

Job Description Pay Range $27.50 - $32.00 per hour. About Us: One of the reasons why we are the nation’s leading parking management expert is because we recognize that “people” are what makes our company successful. It is this recognition that serves as the foundation and building block for our...

Job Description Who are we? At 360 Behavioral Health, we take pride in our long-standing commitment to providing exceptional care for individuals impacted by autism and other developmental delays. With over three decades of expertise, we are one of the original and most established Applied Beha...

Job Description Who are we? At 360 Behavioral Health, we take pride in our long-standing commitment to providing exceptional care for individuals impacted by autism and other developmental delays. With over three decades of expertise, we are one of the original and most established Applied Beha...

Job DescriptionCompany Description Brainlab revolutionized digital medical technology with the introduction of software for radiosurgery and surgical navigation. Today, Brainlab is an industry leader in digital surgery, radiotherapy and integrated operating rooms. Serving physicians, medical p...

Job DescriptionJob Description – The Administrative Coordinator will primarily focus on supporting the property management team with periodic reporting responsibilities. With excellent customer service skills, the Administrative Coordinator will also work with tenants resolving issues and executi...