NewClinical Reviewer, OT Cohere Health Technologies LLCClinical Reviewer, OTCARemote$95,000–$105,000 / yearBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
NewClinical Reviewer, SLP Cohere Health Technologies LLCClinical Reviewer, SLPCARemote$95,000–$105,000 / yearOpportunity Overview: We are looking for a licensed Speech-Language Pathologist (SLP) who has expertise in speech, language, cognitive-communication, voice, fluency, feeding, and swallowing to deliver on Cohere's therapy programs by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.
Implementation Auditor (50487) Western GrowersImplementation Auditor (50487)Irvine, CAUsing close and comprehensive analyses, verify new and existing plans loaded on the Company's claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments. This position will ensure that all new and existing health (medical/dental) insurance plans underwritten by the Western Growers Assurance Trust (WGAT) and those of Pinnacle, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions.
Compliance Manager Camino Health CenterCompliance ManagerSan Juan Capistrano, CAAuditing, Monitoring & Spot Checks: • Conduct or cause to occur internal audits and compliance reviews of identified high-risk areas, including but not limited to the following: • Coding and billing compliance • Clinical documentation • UDS reporting and data integrity • Sliding fee discount program compliance • Credentialing and privileging processes • Perform periodic spot checks of departmental practices to assess compliance between formal audits. The Compliance Manager operates as a hands-on subject matter expert and program owner, working collaboratively with clinical, operational, and administrative teams to implement compliance processes, monitor adherence, investigate concerns, and maintain audit readiness.
Medical Assistant 3 UCSF Medical CenterMedical Assistant 3California, CAUses effective communication skills with patients and staff; demonstrates proper telephone techniques and etiquette; acts as an escort to any patient or family member needing directions; shows sensitivity to differences of culture; demonstrates a positive and supportive manner in which patients / families/ colleagues perceive interactions as positive and supportive. The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
Team Lead - Healthcare - Hospital PFS GuidehouseTeam Lead - Healthcare - Hospital PFSEl Segundo, CA$59,000–$98,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. The Team Lead will and may work closely with their team, project supervisors, operations managers, and the client to work on opportunities with new and emerging approaches to our clients' business processes.
Plan Coder (50456) Western GrowersPlan Coder (50456)Irvine, CAThis position will ensure that all new and existing health (medical/dental/pharmacy) insurance plans underwritten by Western Growers Assurance Trust (WGAT) and those of Pinnacle Claims Management, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions. Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data.
NewHealth Plan Data Scientist SCAN Health PlanHealth Plan Data ScientistLong Beach, CaliforniaRemoteThis role will be a key member of SCAN's Medical Economics Analytics team, responsible for identifying, quantifying, and helping capture total cost of care (TCOC) savings opportunities across the health plan's core medical cost management levers: clinical programs, utilization management (UM) and medical policy, payment integrity, network and contracting, benefit design, coordination of benefits (COB), and supplemental programs. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
Transportation Billing Clerk Bradshaw Home IncTransportation Billing ClerkRancho Cucamonga, CA$20–$22 / hourResponsibilities: Audit carrier invoices, accessorial charges, statements, and rate structures against established contracts, NMFC classification codes, and quote logs to ensure accurate payment processing. This role acts as a pivotal point of contact and audit, coordinating with internal departments, finance teams, freight audit partners, and external carriers to facilitate seamless freight billing, chargeback resolution, and compliance operations.
NewClaims Examiner MedPOINT ManagementClaims ExaminerSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-quality healthcare administrative services. We foster a collaborative and supportive work environment where employees are empowered to grow and make a meaningful impact in the healthcare industry.
Sr. Lead Engineer, Integration & Automation ServiceTitan IncSr. Lead Engineer, Integration & AutomationCA$179,900–$269,900 / yearSupport for Titans at all stages of life: Parental leave and support, up to $20k in fertility services (i.e. IUI and IVF), surrogacy, and adoption reimbursement, on demand maternity support through Maven Maternity, free breast milk shipping through Maven Milk, pet insurance, legal advisory services, financial planning tools, and more. Optimize and maintain complex integrations in Workday Studio (EIB, Core Connectors, Document Transformation, XSLT) and Workato, including net-new builds and major refactors of existing integrations.
DevOps Engineer Applied MedicalDevOps EngineerRancho Santa Margarita, California$80,000–$135,000 / yearApplied Medical is committed to innovation in medical device manufacturing, and the DevOps Engineer supports this mission by ensuring development teams can deliver high-quality software quickly and reliably through modern DevOps practices and cloud-native technologies. The DevOps Engineer collaborates with software developers, architects, and IT teams to build and maintain the platforms and pipelines that enable continuous integration, continuous deployment, and operational excellence.
Application Developer Applied MedicalApplication DeveloperRancho Santa Margarita, California$80,000–$120,000 / yearThe Application Developer collaborates with business analysts, UX/UI designers, database administrators, and DevOps engineers to build integrated applications that meet business needs from concept through deployment. Our dedication to delivering the highest quality products combined with our unique business model allows our team members the ability to truly partner with hospital accounts and contribute in a larger capacity than is possible in most sales positions.
Pharmacy Biller/Office Manager Oncare PharmacyPharmacy Biller/Office ManagerDowney, CaliforniaCompletion of classes in medical terminology, anatomy and physiology, ICD-9 and Current Procedural Terminology (CPT) coding conventions, and disease process from an accredited program. At least two (2) year billing experience in private or health care organization (preferred but required); Experience with physician or ambulatory setting coding preferred.
Medical Informatics Analyst, Consultant Blue Cross and Blue Shield AssociationMedical Informatics Analyst, ConsultantLong Beach, CAThe successful candidate will act as "two-in-a-box" collaborator to share LOB Membership Retention & Growth goals, and Covered CA regulatory reporting, translate complex business problems into structured analytical approaches, design smart analytical tools, and leverage internal data structures to uncover CoHC optimization and member acquisition opportunities. Reporting to the Sr Manager of Medical Informatics, this role is responsible for acting as an AI & Analytics partner to key leaders and cross-functional stakeholders across IFP, Actuarial, HQA, Network Operations, and Finance to achieve their Growth-related business objectives.
Senior/Staff Embedded Software Engineer Horizon Surgical SystemsSenior/Staff Embedded Software EngineerLos Angeles, CaliforniaMicrosurgery in general and Ophthalmology are subfields of surgery for which the surgical outcomes can be significantly improved by robotic systems to allow superior dexterity, precision, accuracy, and visualization beyond the human surgeon’s own capabilities. In your role as an Embedded Software Engineer at Horizon Surgical Systems, you will contribute to the architecture and design of a cutting-edge surgical robotics system, implementing and verifying mission-critical software modules.
Medical Records Director Sun Mar Health CareMedical Records DirectorMonterey Park, CaliforniaDevelop and maintain a good working rapport with inter-department personnel, as well as other departments within the facility to assure that medical records can be properly maintained and problem areas can be identified and corrected. We are a skilled nursing facility looking for dynamic associates to join our clinical team and provide our guests with a care experience that will change their lives!
Clinical Consultant - Physician Associate - Remote UnitedHealth Group Inc.Clinical Consultant - Physician Associate - RemoteCypress, CARemote$91,700–$163,700 / yearPerform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP (The appeals are in response to adverse determinations for medical services related to benefit design and coverage, medical necessity, and the application of clinical criteria of medical policies). Primary Responsibilities: In collaboration with and supervision by an Appeals and Grievances Medical Director, the Physician Associate is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies.
Consultant, Revenue Cycle Alvarez & Marsal Holdings LLCConsultant, Revenue CycleManhattan Beach, CA$100,000–$120,000 / yearOur professionals collaborate with a wide range of organizations, including health systems, physician groups, medical schools, behavioral health institutes, managed care organizations, healthcare investors, medical device companies, and suppliers, as well as vision centers, dental practices, and laboratories. Revenue cycle projects may include, but are not limited to due diligences, performance assessments, enterprise performance improvement, full-scale implementations, and interim management for a broad range of healthcare providers and supporting services companies.
Senior Consultant, Revenue Cycle Alvarez & Marsal Holdings LLCSenior Consultant, Revenue CycleManhattan Beach, CA$140,000–$160,000 / yearRevenue cycle projects may include, but are not limited to: due diligences, performance assessments, enterprise performance improvement, full-scale implementations, and interim management for a broad range of healthcare providers and supporting services companies. Working as a partner to our clients by building consultative relationships you will develop an in-depth understanding of the client's processes, financial positions, and key operational performance drivers in order to surface and address key issues, from the big picture to the smallest details.