Senior Director, Strategic Analytics Tendo Systems IncSenior Director, Strategic AnalyticsCARemote$2,024–$2,025This person will combine deep clinical informatics expertise with hands-on Databricks engineering and AI/ML skill to build algorithms that do two things simultaneously: (1) close documentation and coding gaps that affect risk adjustment, mortality index, and quality attribution, and (2) identify gaps and variation in the actual clinical processes of care that drive the metrics used by national hospital ranking and rating programs (e.g., CMS Star Ratings, U.S. News & World Report, Leapfrog, Vizient, Healthgrades, IBM Watson Health/Chartis 100 Top Hospitals). Maintain expert-level, current knowledge of major hospital ranking, rating, and benchmarking methodologies, including but not limited to: CMS Hospital Compare/Star Ratings, CMS Value-Based Purchasing and Hospital-Acquired Condition programs, U.S. News & World Report Best Hospitals methodology, Leapfrog Hospital Safety Grade, Vizient quality and safety benchmarking, Healthgrades, and payer-specific quality programs.
Senior Forward Deployed Engineer, Servicenow DeloitteSenior Forward Deployed Engineer, ServicenowLos Angeles, CA$155,600–$306,800 / yearDemonstrated use of Claude Code to accelerate delivery, including agentic multi-file workstreams, CLAUDE.md project memory, MCP server integrations, and parallel subagents for concurrent work such as feature development, test generation, and security review. At Deloitte, Forward Deployed Engineers (FDE) don't just build AI solutions, they help clients turn AI ambition into enterprise-scale impact, pairing leading class engineering with pod-based delivery and vertical expertise.
Certified Medical Coder Feed My People Food BankCertified Medical CoderLos Angeles, CaliforniaRemoteAfter work, you will find things to do in every season, including beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment. Under general supervision, according to established policies, procedures and protocols, codes all disease and operations according to accepted classifications.
Authorization Technician II L.A. Care Health PlanAuthorization Technician IILos Angeles, CAAssist in the technical aspects of the retrospective review process for authorizations and Member or Provider Appeals, including, but not limited to computer data entry, logging, copying, preparing of template letters for communication of appeal determinations to members, providers and partners (appeal uphold or overturn) and filing: Set up GNA files for review, log and keep track all due dates for each file. The Authorization Technician II collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by maintaining an accurate database inventory of referral authorizations, retrospective reviews, concurrent reviews and grievance/appeal requests, and prepares UM Activity and Weekly Compliance Reports.
Optometrist - Part Time PARK AVENUE OPTOMETRY INCOptometrist - Part Timepomona, CAPart timeWhy You'll Love This Opportunity: Make a Difference : Serve a loyal, predominantly Hispanic community where your clinical Spanish skills will directly impact lives. Take the next step in your career by emailing your CV to Dr. Rudy Alanis at ralanis.2005@gmail.com or calling 909-622-3531 .
NewUtilization Management Policy Initiatives Registered Nurse Macpower Digital Assets Edge Private LimitedUtilization Management Policy Initiatives Registered NurseLos Angeles, CARemote$102,183–$132,838 / yearThis role ensures that the day to day functions of Utilization Management initiatives comply with regulatory and accreditation requirements such as those stated in contracts, CalAIM Population Health Management (PHM) Policy Guide, National Committee on Quality Assurance (NCQA) Department of Health Care Services (DHCS) All Plan Letters (APLs), and Centers for Medicare and Medicaid Services (CMS) Model of Care (MOC) through sound clinical policy maintenance. Non-negotiable requirements of this position: 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 presentations for new and/or revised Medical Policies to internal stakeholders.
Senior Professional Fee Medical Coder UCSF Medical CenterSenior Professional Fee Medical CoderCACertified Professional Coder (CPC), Certified Coding Specialist-Physician Based (CCS-P), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or licensure equivalent to be evaluated by FPRMO management. Stay current on upcoming coding audits, regulations, trends, OIG initiatives, and applicable carrier initiatives as they pertain to the subspecialties led by the coder to provide pertinent information and tools to the team, minimize risk, and enhance education efforts.
Senior Data Scientist - Clinical Informatics (Analytics Enablement) CVS Health CorpSenior Data Scientist - Clinical Informatics (Analytics Enablement)CA$83,430–$222,480 / yearExperience designing patient-centric data models, feature stores, and dashboards that aggregate longitudinal data across sources, including demographics, encounters, conditions, medications, labs, utilization, cost, and enrichment attributes. A&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses.
Decision Scientist - Clinical Informatics (Clinical Data Standards) CVS Health CorpDecision Scientist - Clinical Informatics (Clinical Data Standards)CA$64,890–$158,620 / yearA&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses. Collaborate with data engineering teams to inform data pipeline development, ensuring clinical data is ingested, transformed, and stored in ways that support downstream analytics needs.
Clinical Documentation Integrity Specialist UCLA Health SystemClinical Documentation Integrity SpecialistLos Angeles, CARemote$100,161.36–$218,718 / yearThis role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies. You will prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria, while identifying denial trends and root causes and provide feedback to the CDI and Clinical teams.
Clinical Documentation Integrity Specialist University of CaliforniaClinical Documentation Integrity SpecialistLos Angeles, CARemote$100,161.36–$218,718 / yearThis role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies. You will prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria, while identifying denial trends and root causes and provide feedback to the CDI and Clinical teams.
NewPatient Service Rep, Primary Care Float Pool (Part Time Non-Benefitted) Children's Hospital of Orange CountyPatient Service Rep, Primary Care Float Pool (Part Time Non-Benefitted)Orange, CaliforniaBending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation Physical Activity Lifting . Lifting (Floor to waist level) - Constant 67 or more%, Lifting (Floor to waist level)- Frequent 36-66%, Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Constant 67 or more%, Lifting (Waist level and above)- Frequent 36-66%, Lifting (Waist level and above) - Occasional 0-35% Sensory Requirements:
BioMed Tech I PHS Bio-Medical ServicesBioMed Tech IInglewood, California$25–$34.91 / hourFull timeOverview: Join our team of dedicated professionals who provide services and operational support to award winning hospitals through roles in supply chain, IT and cybersecurity, clinical engineering, capital procurement, medical coding, project management and more. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Hospitalist Physician - Remote YO AI LabsHospitalist Physician - RemoteLos Angeles, CARemoteWe are seeking experienced Hospitalist Physicians to contribute their medical expertise to a project focused on inpatient care, clinical documentation, and medical record quality . In this role, you will review clinical records, evaluate documentation for accuracy and completeness, and apply your clinical expertise to support high-quality medical data and AI training.
Sr Hospitalist Clinical Reviewer - Remote YO AI LabsSr Hospitalist Clinical Reviewer - RemoteLos Angeles, CARemoteWe are seeking experienced Senior Hospitalist Clinical Reviewers to support a high-impact project focused on inpatient clinical quality, documentation accuracy, and medical review . In this role, you will apply your hospitalist expertise and clinical judgment to evaluate inpatient cases, identify complex or ambiguous clinical scenarios, and provide clear, well-reasoned feedback.
Clinical Documentation Specialist 4 HX - Clinical Doc Integrity - FT Days HYBRID University of California, IrvineClinical Documentation Specialist 4 HX - Clinical Doc Integrity - FT Days HYBRIDIrvine, 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 Claims Auditor (External Audit) Astrana Health, Inc.Senior Claims Auditor (External Audit)Monterey Park, CaliforniaRemote$70,308–$80,000 / yearKnowledge of medical terminology combined with detail knowledge and experience with CPT, HCPCS, DRG, REV, OPS, ASC, ICD10, CRVS, RBRVS, CMS, ICE for Health Plan, DMHC and DHS fee schedules and CMS Medicare regulatory agencies, COB and Third-Party Liability recovery. Detail knowledge and understanding of Industry pricing methodologies, such as Resources-Based Relative Value Scale (RBRVS), Medicare/Medi-Cal fee schedule, All Patient Refined Diagnosis Related Groups (AP-DRG), Ambulatory Payment Classifications (APC), etc.
Business Analyst - REMOTE Molina Healthcare IncBusiness Analyst - REMOTECARemoteCommunicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials.
Commercial Managed Care Collections and Denials Manager - HB Patient Financial Services - FT Days University of California, IrvineCommercial Managed Care Collections and Denials Manager - HB Patient Financial Services - FT DaysAnaheim, 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. Responsibilities: Position Summary: The Commercial/Managed Care Collections/Denials Manager reports to the Assistant Director-Patient Financial Services and is responsible for managing hospital accounts receivables (A/R) and the collections, denial, and workflow activities for Commercial/Managed Care payers – Commercial, Managed Care, Workers Compensation, TriWest/VA and all other third-party payers.
Revenue Assurance Specialist IV - CDM and Epic experience needed Kaiser PermanenteRevenue Assurance Specialist IV - CDM and Epic experience neededPasadena, CAPerforms routine review and maintenance of system codes by: performing a regular review (e.g., quarterly, annually) of coding records to ensure codes are updated, compliant, and accurately reflect policy and regulatory changes; conducting pre- and post-implementation assessments of automated and manual charge capture for quality and accuracy; analyzing moderately complex billing issues related to charges/codes and proposing and implementing action plans to resolve charge capture issues; and contributing to the maintenance of all Current Procedural Terminology (CPT)/ Healthcare Common Procedure Coding System (HCPCS) codes, descriptions, revenue codes, Relative Value Units (RVU) information, and generic codes to assist in the understanding of fee schedule implications. Executes monitoring activities and process improvements by: independently performing tasks that support monitoring activities of the region(s) documentation, charge capture, coding, billing, and/or compliance activities; recording findings in accordance with relevant policies/procedures to ensure complete and consistent data integrity, partnering with other departments to resolve moderately complex deficiencies and/or compliance issues identified through monitoring activities; communicating results of monitoring activities to senior team members and/or department leaders; and implementing corrective action plans resulting from monitoring activities.