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 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.
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.
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.
Account Payable Associate Stratus StaffingAccount Payable AssociatePasadena, CARemote$35–$42We have an open vendor platform and large database of talented applicants covering, Home health, HomeCare, nursing, Hospice, LCT, SNF, ALF, Senior Living, RN LVN, PT, DPT, PTA, OT, SLP, MSW, C-Suite, Administration, Finance, Accounting executives, healthcare management, Travel Nursing, IT, Coding, HIM, Finance, Billing, and a variety of careers from the top ten staffing firms in the country. This role is responsible for managing the accounts payable process, ensuring timely and accurate processing of invoices, managing vendor relationships, maintaining accurate financial records, and maintaining strong relationships with internal teams and external partners.
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 - 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.