Latest Utilization Review jobs in Los Angeles, CA

32 Utilization Review Jobs in Los Angeles, CA

Supervisor - Case Manager/Utilization Review Pyramid Consulting, Inc - Los Angeles, CA, United States Immediate need for a talented Supervisor - Case Manager/Utilization Review . This is a 03+ Months Contract opportunity with long-term potential and is located in Los Angeles, CA(Onsite) . Please 19 days ago
Account Manager Pharmacist Clinical Consultant, Medicaid Fee For Service – Remote in Vermont Optum - Los Angeles, CA, United States their market Identify opportunities to increase efficiency Manages/facilitates custom Pharmacy and Therapeutics (P&T) committees and Drug Utilization Review Board meetings for select clients, per contractual 18 days ago
Registered Nurse - Utilization Review / CDI 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 More than 30 days ago
RN-Quality & Safety Improvement Consultant V, Clinical Quality Consulting (KFH/HP) 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 5 days ago
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CMO Needed| $350-375k Base, Plus Full Benefits| FQHC| Los Angeles, CA 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 2 days ago
Manager Utilization Management 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 13 days ago
Community Outreach Coordinator PM2CM - Los Angeles, California in support of the CED Program. Performs detailed contract compliance review using the B2GNow system to monitor prompt payment and the utilization of Local, Small, Emerging, & Disabled Veteran (LSEDV) firms 5 days ago
SENIOR WORKERS' COMPENSATION ANALYST 1769 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 7 days ago
Manager of Utilization Management, RN Kaiser Permanente - Los Angeles, California , State, TJC, NCQA, other regulatory agencies and internal standards and requirements. Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services 14 days ago
RN-Peds/PICU or Perinatal (L&D, Perinatal) Quality & Safety Improvement Consultant IV, Clinical Quality Consulting Kaiser Permanente - Los Angeles, California with the development of corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, member satisfaction surveys, and auditing surveys; ensuring process 22 days ago

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