Senior Forward Deployed Engineer, Servicenow DeloitteSenior Forward Deployed Engineer, ServicenowCosta Mesa, 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.
Clinical Documentation Integrity Specialist Adventist Health SystemClinical Documentation Integrity SpecialistLos Angeles, CAJob Summary: Reviews, evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record and ensure it is in compliance with government and other regulations. Essential Functions: Evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record.
Clinical Documentation Integrity Specialist (Hybrid, White Memorial) Adventist HealthClinical Documentation Integrity Specialist (Hybrid, White Memorial)Los Angeles, CAJob Summary: Reviews, evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record and ensure it is in compliance with government and other regulations. Essential Functions: Evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record.
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.
Data Integration Analyst AI & Risk Adjustment ReveleerData Integration Analyst AI & Risk AdjustmentCARemoteWe especially welcome candidates transitioning from academic or research careers, for example, graduate study or research experience in fields such as molecular biology, genetics, physics, chemistry, or other quantitative sciences, who want to apply their talents in a fast-moving, high-impact commercial environment. With regulatory expertise and transparent, human-in-the-loop AI at its core, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.
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.
Utilization 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.
Specialty Physician Coder ICONMA, LLCSpecialty Physician CoderFountain Valley, CA$38.53–$41.57 / hourThis role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines.
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.
NewPatient Service Rep, Sea View - Irvine Children's Hospital of Orange CountyPatient Service Rep, Sea View - IrvineIrvine, 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:
Special Investigation Unit Investigative Analyst III L.A. Care Health PlanSpecial Investigation Unit Investigative Analyst IIILos Angeles, CAUses knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability, reimbursement methodologies, and relevant laws to find suspicious patterns in claims data, provider enrollment data, and other sources. Care's mission is to provide access to quality health care for Los Angeles Countys vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
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.
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.
Nurse Itemized Bill Reviewer IBR Analyst MachinifyNurse Itemized Bill Reviewer IBR AnalystCA$80,000–$90,000 / yearAt Machinify, we're constantly reimagining what's possible in our industry-creating disruptively simple, powerfully clear ways to maximize our clients' financial outcomes today and drive down healthcare costs tomorrow. As part of the Complex Payment Solutions team, you will, as a Nurse Itemized Bill Reviewer (IBR Analyst), be responsible for reviewing facility insurance claims to determine true and accurate charges.
NewSupervisor Grievance and Appeals CalOptimaSupervisor Grievance and AppealsOrange, CA$84,092–$134,548 / yearBachelor's degree PLUS 1 year of experience of health care management experience, preferably in a managed care environment in related areas of responsibility of utilization management, quality management, customer service or grievances and appeals required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. We are hoping you will join us as a Supervisor Grievance and Appeals and help shape the future of healthcare where you'll be an integral part of our GA - Provider Disputes team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders.
Medical Director, Utilization Management L.A. Care Health PlanMedical Director, Utilization ManagementLos Angeles, CAThis position plays a critical role in the mitigation of Fraud, Waste and Abuse (FWA) and requires proactive analysis of service level utilization data to identify trends, outliers and emerging risk areas and recommend corrective action to minimize utilization variation, prevent improper payments and ensure financial stewardship. The Medical Director, Utilization Management provides clinical oversight of authorization decision making and processing, pre and post payment claims review activities, payment integrity clinical validation and program integrity functions.
Medical Assistant/ Insurance verifier , authorization specialist Apex Practice Management GroupMedical Assistant/ Insurance verifier , authorization specialistNorthridge, CAFull timeThe ideal candidate will be responsible for obtaining insurance authorizations and check eligibility for medical procedures and services, ensuring timely approvals to facilitate patient care. - Communicate with healthcare providers, insurance companies, and patients to gather necessary information.
Medical Director, Clinical Policy L.A. Care Health PlanMedical Director, Clinical PolicyLos Angeles, CAThis position ensures clinical policies and utilization management frameworks are evidence-based, operationally sound, compliant with regulatory and accreditation requirements, and aligned with organizational goals related to quality, safety, affordability, and member experience. The Medical Director oversees policy architecture, authorization strategy, and utilization oversight across all lines of business, ensuring clinical intent is accurately translated into authorization requirements, coding structures, and system configuration through partnership with internal teams.
Pharmacovigilance Specialist Grifols SAPharmacovigilance SpecialistLos Angeles, CA$95,000–$105,000 / yearExample: If a job level requires a Bachelor's degree plus 4 years of experience, an equivalency could include 8 years of experience, an Associate's degree with 6 years of experience, or a Master's degree with 2 years of experience. Serves in an advisory capacity including activities such as product monographs review; draft responses to pharmacovigilance requests from regulatory agencies; participates in the drafting and implementation of pharmacovigilance contracts and agreements.