Utilization Review Supervisor RN CorVel CorpUtilization Review Supervisor RNRancho Cucamonga, CARemote$77,960–$120,368 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
CA Based Licensed Nurse Care Manager, Adult Included HealthCA Based Licensed Nurse Care Manager, AdultCorona, CARemote$35.43–$50 / hourbehavioral health, urgent care, etc.) and health care navigation products and services offered at no cost for employees and dependents Generous Paid Time Off ("PTO") and Discretionary Time Off ("DTO") 12 weeks of 100% Paid Parental leave Family Building Benefit with fertility coverage and up to $25,000 for Surrogacy & Adoption financial assistance Compassionate Leave (paid leave for employees who experience a failed pregnancy, surrogacy, adoption or fertility treatment) 11 Holidays Paid with one Floating Paid Holiday Work-From-Home reimbursement to support team collaboration and effective home office work 24 hours of Paid Volunteer Time Off ("VTO") Per Year to Volunteer with Charitable Organizations . As a telephonic Nurse Care Manager you will report to the Manager, Care and Case Management and will guide members through complex medical and behavioral Health situations, partnering with a diverse clinical team that includes a variety of healthcare professionals, care coordinators, and records specialists, to deliver integrated remote care in a creative way.
Clinical Retention Specialist (West Region - AZ, CO, HI, ID, KS, MT, NE, NV, OR, UT, WA) Insulet CorpClinical Retention Specialist (West Region - AZ, CO, HI, ID, KS, MT, NE, NV, OR, UT, WA)CARemote$87,200–$130,850 / yearInsulet's flagship innovation, the Omnipod 5 Automated Insulin Delivery System, integrates with a continuous glucose monitor to manage blood sugar with no multiple daily injections, zero fingersticks, and can be controlled by a compatible personal smartphone in the U.S. or by the Omnipod 5 Controller. Identify early indicators of disengagement or churn through data assessment and analytics in partnership with the data science teams and collaborate with Customer Success teams to deploy targeted, regionally informed save strategies.
Clinical Athletic Trainer Children's Hospital Los AngelesClinical Athletic TrainerLos Angeles, CaliforniaRemotePer diemPurpose Statement/Position Summary: The primary role of the Clinical Athletic Trainer (ATC) is to assist in the examination and treatment of patients under the direction of the physician and/or Sports Medicine Program manager by performing the essential functions of the job. The position will collaborate with multi-disciplinary team and provide direct assistance to other medical providers such as physicians, advanced practice providers, physical therapists, medical assistants, and registered nurses in providing care for our patients at CHLA.
Bilingual Spanish Community Health Worker (Orange County) SHPCA SCAN Health PlanBilingual Spanish Community Health Worker (Orange County)Santa Ana, CaliforniaRemote$21.78–$31.52 / hourPerform Enhanced Care Management (ECM) activities related to specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk for Avoidable Hospital Or ED Utilization, Adults Living In the Community At Risk of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back to the Community. Perform assessments for Medi-Cal/Medicare dual-eligible members referred to Complex Care Management for Long-Term Services and Supports (LTSS) and assist the Registered Nurse in determining Nursing Facility Level of Care.
Bilingual Spanish Community Health Worker (Orange County) SCAN Health PlanBilingual Spanish Community Health Worker (Orange County)Santa Ana, CaliforniaRemotePerform Enhanced Care Management (ECM) activities related to specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk for Avoidable Hospital Or ED Utilization, Adults Living In the Community At Risk of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back to the Community. Perform assessments for Medi-Cal/Medicare dual-eligible members referred to Complex Care Management for Long-Term Services and Supports (LTSS) and assist the Registered Nurse in determining Nursing Facility Level of Care.
Utilization Review Supervisor RN CorVel Healthcare CorporationUtilization Review Supervisor RNRancho Cucamonga, CARemote$77,960–$120,368 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
CA Medical Case Manager II CorVel CorpCA Medical Case Manager IILos Angeles, CARemote$32.18–$48.68 / hourIn addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel's proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Director, Market Access Strategy iRhythm Holdings IncDirector, Market Access StrategyCARemote$170,000–$221,000 / yearCollaborate with Payer Marketing, HEOR, Clinical, and Legal/Compliance partners to translate clinical and real‑world evidence into compelling, compliant payer value propositions and scientific communications. Independently design, negotiate, and execute innovative payer contracts, including value‑based care, outcomes‑based agreements, shared savings, subscription models, and episodic/bundled arrangements.
NewGrievance and Appeals Nurse (State) Centene Corporation GroupGrievance and Appeals Nurse (State)CARemote$27.02–$48.55 / hourReview clinical data to determine claim payment based on company policies and National Committee for Quality Assurance (NCQA) guidelines, including overturning denied claims, upholding the denials and submitting cases to the Medical Director for review. Position Purpose: Facilitate medical necessity grievance, appeals and denials including disposition of denials notification letters, review of clinical information to determine if medical necessity criteria are met.
Senior Medical Science Liaison - Pacific Southwest Teva Pharmaceutical Industries LtdSenior Medical Science Liaison - Pacific SouthwestLos Angeles, CARemote$160,000–$175,000 / yearAdditional benefits include, but are not limited to, Employee Assistance Program, Employee Stock Purchase Plan, Tuition Assistance, Flexible Spending Accounts, Health Savings Account, Life Style Spending Account, Volunteer Time Off, Paid Parental Leave, if eligible, Family Building Benefits, Virtual Physical Therapy, Accident, Critical Illness and Hospital Indemnity Insurances, Identity Theft Protection, Legal Plan, Voluntary Life Insurance and Long Term Disability and more. Terminal scientific degree (examples: PhD, MD, DO, PharmD, PsyD, DNP), or Master's degree in Nursing with current APRN licensure with a specialization in Neurology/minimum 1 year of relevant therapeutic and/or clinical experience in neurology fields.
Senior Medical Science Liaison - Solid Tumor - Southern CA/AZ Takeda Pharmaceutical Co LtdSenior Medical Science Liaison - Solid Tumor - Southern CA/AZCARemote$169,400–$266,200 / yearResponsible for establishing relationships and engaging in peer-to-peer level scientific discussions around emerging data, treatment guidelines, molecular pathways, mechanism of action Takeda Oncology products including clinical outcomes and research opportunities. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Medical Science Liaison CORE - West Azurity Pharmaceuticals IncMedical Science Liaison CORE - WestCARemoteMedical Affairs at Azurity Pharmaceuticals, a privately held company delivering innovative medicines for overlooked patients across 50+ countries, drives scientific and clinical initiatives with a portfolio of 40+ brands spanning 10 dosage forms and 9 therapeutic areas. As an industry leader in providing unique, accessible, and high-quality medications, Azurity leverages its integrated capabilities and vast partner network to continually expand its broad commercial product portfolio and robust late-stage pipeline.
Medical Science Liaison Anti-Infectives - West Azurity Pharmaceuticals IncMedical Science Liaison Anti-Infectives - WestCARemoteMedical Affairs at Azurity Pharmaceuticals, a privately held company delivering innovative medicines for overlooked patients across 50+ countries, drives scientific and clinical initiatives with a portfolio of 40+ brands spanning 10 dosage forms and 9 therapeutic areas. MSLs are the field scientific experts in anti-infectives and treatment options within this therapeutic area and will support strategic Medical Affairs initiatives, evidence-generation activities, and field readiness efforts associated with the continued growth of the anti-infectives portfolio.
Utilization Management Clinician Behavioral Health Night Shift - 4 Days CVS Health CorpUtilization Management Clinician Behavioral Health Night Shift - 4 DaysCARemote$54,095–$142,576 / yearAbility to manage crisis calls, apply clinical judgment to assess risk, determine support needs, and coordinate appropriate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary. Join our Utilization Management team and help ensure members receive timely, appropriate behavioral health services while making a meaningful impact on outcomes.
NewLicensed Mental Health Professional The Stepping Stones Group LLCLicensed Mental Health ProfessionalLos Angeles, CARemote$43–$47 / hourCenter-Based ABA Therapy. Summer Intensive Program.
Online Adjunct Instructor - Foundations of Adult-Gerontology Primary Care Nurse Practitioner Practice Rasmussen College LLCOnline Adjunct Instructor - Foundations of Adult-Gerontology Primary Care Nurse Practitioner PracticeCARemoteAbout Us: Rasmussen University, a university accredited by the Higher Learning Commission, an institutional accreditation agency recognized by the U.S. Department of Education (www.hlcommission.org), is dedicated to changing lives and the communities it serves through innovative educational programs. Student support and outreach that supports the success of students is accomplished through faculty availability to students in all courses through synchronous or asynchronous communication and meetings to help students achieve the learning objectives for their course(s).
CA Medical Case Manager II CorVel Healthcare CorporationCA Medical Case Manager IILos Angeles, CARemote$32.18–$48.68 / hourPart timeIn addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Senior Medical Science Liaison - West Region SpringWorks Therapeutics IncSenior Medical Science Liaison - West RegionCARemote$167,500–$220,000 / yearMSL being able to develop and maintain an advanced scientific, medical, and product knowledge base, ability to communicate key insights learned, and disseminate critical scientific data to external stakeholders; including but not limited to academic/scientific/clinical experts, payers, and patient organizations. Essential Duties and Responsibilities: Identify Key Opinion Leaders (KOLs) and establish and maintain strong and deep scientific relationships with KOLs across multi-specialty disciplines, connecting to KOLs in academic centers and community practices at the local, regional, and national level.
Medical Director, Utilization Management Home Health, Acute & Post-Acute Clover Health Investments CorpMedical Director, Utilization Management Home Health, Acute & Post-AcuteCARemote$242,300–$315,000 / yearLeveraging CMS Home Health regulations, the Medicare Benefit Policy Manual, National and Local Coverage Determinations (NCD/LCD), Milliman Care Guidelines, and Clover Health clinical policies, you will help ensure consistent, evidence-based decision-making that supports high-quality member care. You''ll partner closely with the Home Health RN Lead, Utilization Management nurses, providers, and cross-functional teams to improve clinical outcomes, promote appropriate utilization, and advance Clover''s commitment to delivering exceptional Home Health services.