Clinical Configuration Analyst Cohere Health Technologies LLCClinical Configuration AnalystCARemote$70,000–$80,000 / yearReporting into our Senior Manager, PaaS Value Delivery, you will be part of a small, fast-paced team working directly with client-facing team members to understand and deliver key clinical configurations that are integral to helping new and existing clients meet their prior authorization automation goals. Serve as a technical SME for client-facing analysts during each stage of the customer lifecycle: providing education and answers to questions around configurability of client platform requirements; occasionally interfacing directly with clients to address issues.
Utilization Management Nurse, Senior- Medicare Concurrent Review Blue Cross and Blue Shield AssociationUtilization Management Nurse, Senior- Medicare Concurrent ReviewWoodland Hills, CARequires a current California RN License Requires at least 5 years of prior relevant experience Requires strong communication and computer navigation skills Desires strong teamwork and collaboration skills Requires independent motivation and strong work ethic Requires strong critical thinking skills Hybrid Virtual Work This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need. Your Work In this role, you will: Perform prospective, concurrent and retrospective utilization reviews and first level determination approvals for members using BSC and CMS evidenced based guidelines, policies and nationally recognized clinal criteria for BSC Medicare line of business.
Utilization Management Nurse, Senior Blue Cross and Blue Shield AssociationUtilization Management Nurse, SeniorWoodland Hills, CAThe Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans, discharge planning, and compliance requirements while supporting clinical consistency, process improvement, quality, timeliness, and appropriate escalation of high-risk cases. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Behavioral Health Utilization Mgmt Clinician, Senior Blue Cross and Blue Shield AssociationBehavioral Health Utilization Mgmt Clinician, SeniorLong Beach, CAIn this role, you will: Perform prospective & concurrent utilization reviews and first level determination approvals for members admitted to facilities using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare as needed. The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal criteria across multiple lines of business.
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - PreArrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union)Los Angeles, CA$26–$41.28 / hourWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.
Financial Clearance Specialist III - Prearrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - Prearrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union)Los Angeles, CA$26–$41.28 / hourWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.
RN, Clinical Documentation Integrity Specialist myPlace HealthRN, Clinical Documentation Integrity SpecialistLos Angeles, CaliforniaOperating within the PACE model, the CDI Specialist conducts clinically supported chart reviews, identifies documentation opportunities, and collaborates with physicians, nurse practitioners, and care teams to support compliant CMS-HCC capture and sustainable documentation improvement. This clinically credentialed role partners with providers, interdisciplinary care teams, and risk adjustment stakeholders to ensure documentation reflects each participant’s clinical complexity, disease burden, severity of illness, and care needs.
Utilization Management Assistant - Utilization Management Providence Health & ServicesUtilization Management Assistant - Utilization ManagementMission Hills, CA$24–$31.52 / hourTogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care.
Sr. Digital Product Development Manager Hyundai Capital AmericaSr. Digital Product Development ManagerIrvine, CAThis role partners with Product and business stakeholders to clarify outcomes, translates needs into technical plans and requirements, governs vendor delivery (scope, quality, timelines), and contributes directly through coding, code reviews, and ongoing platform support in an agile environment. Digital Product Development Manager leads an outsourced delivery partner who provides scalable and secure solutions that meet business needs while also serving as a hands-on technical leader who can design, build, and maintain key platform capabilities.
Principal Software Engineer - Gen4 Airborne Radar (APG-82) RTX CorpPrincipal Software Engineer - Gen4 Airborne Radar (APG-82)El Segundo, CARTX considers several factors when extending an offer, including but not limited to, the role, function and associated responsibilities, a candidate's work experience, location, education/training, and key skills. As part of our commitment to maintaining a secure hiring process, candidates may be asked to attend select steps of the interview process in-person at one of our office locations, regardless of whether the role is designated as on-site, hybrid or remote.
Principal Software Engineer - Gen4 Radar / Ground Station RTX CorpPrincipal Software Engineer - Gen4 Radar / Ground StationEl Segundo, CAExperience with implementing software changes to resolve Fortify findings, providing inputs and updates to the Plan Of Action & Milestones (POA&M), and assembled all required artifacts onto media and working a Certificate to Field (CtF) with the Delegated Authorizing Official from 16th AF cyber team. RTX considers several factors when extending an offer, including but not limited to, the role, function and associated responsibilities, a candidate's work experience, location, education/training, and key skills.
Vermont Rural Healthcare IT and HIM Leadership Opportunities Rural Staffing ServicesVermont Rural Healthcare IT and HIM Leadership OpportunitiesVermont, VermontRural Staffing Services® partners with rural hospitals, clinics, community health centers, long-term care organizations, and healthcare systems throughout Vermont to identify experienced information technology and health information leaders who understand the unique needs of rural healthcare. These opportunities may include leadership within Critical Access Hospitals, Rural Health Clinics, Federally Qualified Health Centers, community hospitals, long-term care organizations, and integrated rural healthcare systems.
Primary Care Advanced Practitioner (Cantonese Fluency Required) Florence HealthPrimary Care Advanced Practitioner (Cantonese Fluency Required)Monterey Park, CAFull timeRole Overview As a Primary Care Advanced Practitioner, you will work collaboratively within a small, close-knit care team. Qualifications: - Certified Nurse Practitioner (NP) or Physician Assistant (PA) with experience in primary care (internal medicine, family medicine, or geriatrics preferred).
DRGV Auditor II R1 RCM IncDRGV Auditor IICA$52,025–$97,528.69 / yearWe are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. The Company's employment practices, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law.
Director, Screening Compliance Guardant Health IncDirector, Screening ComplianceCAAdvice on legal issues throughout the medical device lifecycle related to clinical research, market access and reimbursement, product launches, commercialization, advertising and promotion, social media, patient access and financial assistance programs. Guardant tests help improve outcomes across all stages of care, including screening to find cancer early, monitoring for recurrence in early-stage cancer, and treatment selection for patients with advanced cancer.
Nurse Practitioner - Downtown Los Angeles (CA License required) Greater Good HealthNurse Practitioner - Downtown Los Angeles (CA License required)Los Angeles, CaliforniaGGH is dedicated to building an inclusive, diverse, equitable, and accessible workplace that fosters a sense of belonging – so if you’re excited about this role but your experience doesn’t align perfectly with every qualification in the job description, we encourage you to still consider applying. Whether through our own senior-focused primary care clinics or our suite of integrated clinical solutions for health plans and provider groups, we are making value-based care more accessible and more effective.
Senior Clinical Research Associate - West Coast/Oncology Systimmune IncSenior Clinical Research Associate - West Coast/OncologyLos Angeles, CA$110,000–$145,000 / yearPrepare the study reference manual, including liaising with the Contract Research Organization (CRO) team (i.e., central lab, specialty labs and vendors) to ensure efficient preparation and delivery of study materials to investigator sites. CRA is responsible for the management and oversight of their assigned clinical study sites to ensure data quality and patient safety in accordance with ICH-GCP guidelines, local regulations, and applicable SOPs.
NewAssistant Trauma Coordinator - Trauma Services - Days - FT - Orange University of California, IrvineAssistant Trauma Coordinator - Trauma Services - Days - FT - OrangeOrange, CaliforniaFull timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
Senior Clinical Research Associate - West Coast/Oncology SystimmuneSenior Clinical Research Associate - West Coast/OncologyLos Angeles, CAFull timePrepare the study reference manual, including liaising with the Contract Research Organization (CRO) team (i.e., central lab, specialty labs and vendors) to ensure efficient preparation and delivery of study materials to investigator sites. CRA is responsible for the management and oversight of their assigned clinical study sites to ensure data quality and patient safety in accordance with ICH-GCP guidelines, local regulations, and applicable SOPs.
Physical Therapist Center Therapy Director Concentra Inc.Physical Therapist Center Therapy DirectorLos Angeles, CA$95,000–$130,000 / yearThis position is eligible to earn a base compensation rate in the state range of $95,000 to $130,000 annual salary depending on job-related factors as permitted by applicable law, such as level of experience, geographic location where the work is performed, and/or seniority. Masters use of clinical systems to ensure efficient and excellent supportive documentation, appropriate and optimal coding levels, charge capture, and follow-through on all patient care orders.