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Processor Jobs in Wilmington, CA

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Senior Manager, Applied Science Cohere Health Technologies LLC

Remote

$225,000–$240,000 / year

As a player-coach, you''ll combine hands-on technical contributions with team leadership, helping to establish best practices, mentor team members, and drive high-impact solutions in close partnership with Product, Engineering, Clinical, and Analytics stakeholders. 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.

30 days ago

Healthcare Analyst II Cohere Health Technologies LLC

Remote

$85,000–$92,000 / year

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. 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.

30+ days ago

Developer I - BI & Analytics Inland Empire Health Plan

Rancho Cucamonga, CA

The role is expected to design and develop scalable solutions using AI tools and machine-learning models; utilize big data computation and storage tools to create prototypes and datasets. Be an independent self-starter who is driven to success, takes great pride in accomplishments and works with a sense of urgency to meet deadlines and address competing priorities.

30+ days ago

Executive Director, HIMS Services City of Hope

City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. This enterprise leader oversees HIMS operations and regulatory compliance, Clinical Documentation Integrity, coding and data quality, documentation support and release of information, document imaging, records management and related functions.

23 days ago

Clinical Director LifeStance Health

Irvine, California

Partners with Practice Group Manager and other team leaders to support new clinicians through provision of clinically focused regional onboarding training, promoting caseload ramp, and engaging in new employee orientation. The Clinical Director will provide oversight and support for psychotherapy clinicians, engaging through coaching and education of new and tenured clinicians and enhancing ongoing clinician professional growth and development.

21 days ago

Director, Risk Adjustment Prospective Programs Inland Empire Health Plan

Rancho Cucamonga, California

$154,128–$204,214.40 / year
Full time

Advanced Analytics & Suspecting Engine Governance: Suspecting Models: Partner with Healthcare Data Analytics teams to optimize "suspecting engines" that evaluate historic claims, prescription data, lab results, and social determinants of health (SDOH) to predict undocumented or under-documented chronic illnesses. Operating within a network structure comprised of independent, Fee-for-Service (FFS) practices and delegated Independent Physician Associations (IPAs), this Director leads programs such as in-home and virtual assessments, pre-visit suspecting, point-of-care documentation supports, and concurrent validation.

14 days ago

RAC Manager Prime Healthcare Services Inc

Ontario, CA

$71,760–$94,619.20 / year

Extensive knowledge of nursing care, clinical measurement tools, and clinical outcomes; ability to establish cooperative working relationship with diverse groups and individuals, the medical staff, and other healthcare disciplines; program and database development a plus 1+ year of clinical experience in acute care setting preferred. Working with the Supervisor(s), a RAC manager functions as a subject matter expert (SME) for the appeals process and takes an active role in managing the process and coordinating with the RAC team, Corporate Utilization Review and Clinical appeals team.

30 days ago

DRG Coder Astrana Health Inc

Orange, CA

In an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the Senior DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis. The Senior DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment.

30+ days ago

Clinical Integrity Manager Cohere Health Technologies LLC

Remote

$108,000–$125,000 / year

As a subject matter expert in utilization management, this role actively supports delegated clinical operations, participates in new client implementations, evaluates emerging clinical needs, and ensures seamless integration between clinical operations and technology. 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.

30+ days ago

Manager, Data Science Inland Empire Health Plan

Rancho Cucamonga, California

$154,128–$204,214.40 / year
Full time

The Manager, Data Science enables the development of production-grade ML models, building GenAI applications (LLMs, RAG pipelines, prompt engineering, finetuning, multimodal models), and drives measurable business outcomes. This role requires a strong balance of technical expertise in advanced machine learning (including Generative AI), leadership experience, health care domain knowledge preferably in the managed care space, and the ability to align AI-driven solutions with business strategy.

30+ days ago

Medical Assistant 3 UCSF Medical Center

California, CA

Uses 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.

30+ days ago

Home Health Registered Nurse (RN) - Van Nuys CVHCare

Van Nuys, CA

Part time

We provide an entire internal operational support team for our clinicians to handle the tasks of pre-populating the medication reconciliation, tracking down DME orders, getting MD signatures, coding, lab follow-up, etc., truly allowing you to function independently, with the flexibility to make your own schedule and plan patient visits around other commitments if needed. Locations: Area #40 covers the following cities: North Hollywood, Sherman Oaks, Studio City, Sun Valley, Toluca Lake, Universal City, Valley Glen, Valley Village, Van Nuys.

Today

Home Health Registered Nurse (RN) - Tarzana CVHCare

Tarzana, CA

Part time

We provide an entire internal operational support team for our clinicians to handle the tasks of pre-populating the medication reconciliation, tracking down DME orders, getting MD signatures, coding, lab follow-up, etc., truly allowing you to function independently, with the flexibility to make your own schedule and plan patient visits around other commitments if needed. As well as customized care and patient education about disease management, the Home Health RNs provide a variety of specialized services, such as Simple to Complex Wound Therapy, Post-Surgical Care Management, and Ostomy Care Management.

Today

Clinical Documentation Integrity Specialist - Full Time (On-Site) - Days - 8hr QVH Emanate Health Medical Center

West Covina, CA

$49.55–$76.80 / hour

Minimum License Requirement: ACDIS Certified Clinical Documentation Specialist (CCDS) or AHIMA Certified Documentation Integrity Practitioner (CDIP) required within 1 year of hire/transfer. The Clinical Documentation Integrity Specialist (CDIS) facilitates the overall quality, completeness, and accuracy of clinical documentation through concurrent interaction with providers and other members of the healthcare team.

16 days ago

Home Health Registered Nurse (RN) - Glendale CVHCare

Glendale, CA

Part time

We provide an entire internal operational support team for our clinicians to handle the tasks of pre-populating the medication reconciliation, tracking down DME orders, getting MD signatures, coding, lab follow-up, etc., truly allowing you to function independently, with the flexibility to make your own schedule and plan patient visits around other commitments if needed. As well as customized care and patient education about disease management, the Home Health RNs provide a variety of specialized services, such as Simple to Complex Wound Therapy, Post-Surgical Care Management, and Ostomy Care Management.

Today

Primary Care Advanced Practitioner (Cantonese Fluency Required) Florence Health

Monterey Park, CA

Title: Primary Care Advanced Practitioner (Cantonese Fluency Required) Company Overview We are an independent primary care practice dedicated to providing exceptional care to our patients. Role Overview As a Primary Care Advanced Practitioner, you will work collaboratively within a small, close-knit care team.

30+ days ago

Nurse Practitioner - Downtown Los Angeles (CA License required) Greater Good Health

Los Angeles, California

GGH 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.

30+ days ago

NURSE PRACT 2 UCSF Medical Center

Includes taking histories, performing physical examinations, responding to changes in patient status, performing consults, ordering or furnishing medications/diagnostic tests/treatments/therapies/consultations/referrals/durable medical equipment (DME)/home health services. Our CT surgery APPs manage patients collaboratively across the inpatient continuum of care (in the ICU setting as well as the floor) with CT Surgery Fellows, Cardiac Surgeons, and Intensivists, perform bedside procedures, and may assist in the operating room.

30+ days ago

ED, Risk Adjustment Strategy & Transformation Kaiser Permanente

Pasadena, CA

Through collaborative leadership, shared accountability, and enterprise-wide partnership, the Executive Director will help strengthen member outcomes, enhance provider and patient experiences, improve operational effectiveness, support reimbursement integrity, and advance Kaiser Permanentes long-term clinical and financial performance. Working through established governance structures, including the Care Delivered, Value Captured, Unrivaled Experience (CDVCUE) Board and its cross-functional stakeholders, the Executive Director will facilitate collaboration, support strategic alignment, promote transparency, and help ensure coordinated execution across interconnected initiatives.

30+ days ago

Director, Screening Compliance Guardant Health Inc

Advice 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.

30+ days ago

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Processor Jobs in Wilmington, CA

Senior Manager, Applied Science Cohere Health Technologies LLC

Healthcare Analyst II Cohere Health Technologies LLC

Developer I - BI & Analytics Inland Empire Health Plan

Executive Director, HIMS Services City of Hope

Clinical Director LifeStance Health

Director, Risk Adjustment Prospective Programs Inland Empire Health Plan

RAC Manager Prime Healthcare Services Inc

DRG Coder Astrana Health Inc

Clinical Integrity Manager Cohere Health Technologies LLC

Manager, Data Science Inland Empire Health Plan

Medical Assistant 3 UCSF Medical Center

Home Health Registered Nurse (RN) - Van Nuys CVHCare

Home Health Registered Nurse (RN) - Tarzana CVHCare

Clinical Documentation Integrity Specialist - Full Time (On-Site) - Days - 8hr QVH Emanate Health Medical Center

Home Health Registered Nurse (RN) - Glendale CVHCare

Primary Care Advanced Practitioner (Cantonese Fluency Required) Florence Health

Nurse Practitioner - Downtown Los Angeles (CA License required) Greater Good Health

NURSE PRACT 2 UCSF Medical Center

ED, Risk Adjustment Strategy & Transformation Kaiser Permanente

Director, Screening Compliance Guardant Health Inc

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