Utilization Review Jobs in Los Angeles, CA

TactStaff - Los Angeles, CA, US

in good standing Preferred: 1. 2+ years of ambulatory care experience 2. BSN 3. Utilization review experience Job Duties: 1. Review occurrence reports and the related pertinent medical records to determine

from: staffingfuture.com - More than 30 days ago

Kaiser Permanente - Los Angeles, California

compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements. Provides direction to staff regarding utilization review, care coordination, discharge planning

from: HealtheCareers.com - 5 days ago

Internal Revenue Service - Los Angeles, California (+6 locations)

plans and determine impact of changes on program goals. Experience using knowledge of cross-functional programs and their interrelationship with assigned program to conduct reviews, studies/projects 103409.0-167336.0

from: Usajobs.gov - 15 days ago

L.A. Care Health Plan - Los Angeles, California

License or Registered Nurse (RN); current and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required

from: HealtheCareers.com - 15 days ago

CITY OF LOS ANGELES, CA

Board (WCAB); medical and anatomical terminology; the Permanent Disability Rating System; the Independent Medical Review (IMR), Utilization Review (UR), and Independent Bill Review (IBR) rules $95,693.00 - $121,500.00 Annually

from: Governmentjobs.com - 22 days ago

L.A. Care Health Plan - Los Angeles, California

information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims

from: HealtheCareers.com - 15 days ago

Kaiser Permanente - Los Angeles, California

through utilization review, clinical records audit, claim denials, member satisfaction surveys, and auditing surveys for their cost effectiveness and impact on department functioning; ensuring process

from: HealtheCareers.com - 27 days ago

Provider Healthcare - Los Angeles, California, United States

primary care to patients of all ages Participate in the development of clinic protocols and procedures to ensure quality medical care Participate in utilization and peer review programs which evaluates

from: doccafe.com - 24 days ago

CITY OF LOS ANGELES, CA

; the Permanent Disability Rating System; the Utilization Review (UR) process; and other necessary knowledge, skills, and abilities. Additional job analysis information can be obtained by going to https $96,006.00 - $142,401.00 Annually

from: Governmentjobs.com - 29 days ago

APN Consulting - Torrance, California

Care experience (can consider 1.5 years) Experience with Utilization Review and Discharge Planning Experience with InterQual 1st-time travelers acceptedFacility Name: Unit: Shift:Day 5x8-Hour (08:00 - 16

from: resume-library.com - 2 days ago