Utilization Review Jobs in Irvine, CA

We are actively recruiting for an CAL RNs to join our rapidly growing Population Health team.  The primary role of the Care Manager will be to provide our patients with on-demand telephone-based care management services through a 24/7 Nurse Advice Line (i.e. telephone triage). &# More...

The Program Director is a vital leadership position and integral to the successful management of our program. The Program Director provides direction and supervision to the entire staff including the clinicians he/she oversees. Aside from managerial responsibilities the Program Direct More...

Application Instructions:Complete all sections and fields on the application and attach all required documents incomplete applications may not be considered.Include all relevant education training and/or experience on the application.Do not include any personally identifiable confide More...

We are actively recruiting for an CAL RNs to join our rapidly growing Population Health team.  The primary role of the Care Manager will be to provide our patients with ondemand telephonebased care management services through a 24/7 Nurse Advice Line (i.e. telephone triage). &#xa More...

The Appeals Support Representative role directly supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.This is a fulltime remote position that will work Monday through Friday 8:00am4:30pm EST or 8:305:00 More...

Job Description SummaryStudent Program/CoordinatorResponsibilitiesPlan and implement programming for first year students to aid in their transition to Chapman Host weekly office hours for students in community Be a resource within your college for First Year students Work collaborativ More...

The Appeals Support Representative role directly supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.This is a fulltime remote position that will work Monday through Friday 8:00am4:30pm EST or 8:305:00 More...

The Appeals Support Representative role directly supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.This is a fulltime remote position that will work Monday through Friday 8:00am4:30pm EST or 8:305:00 More...

Regional Manager Quality Review for ID/DDGeorgia remote@Orchard LLC is supporting a notforprofit corporation that partners with public and private sectors to create highquality safe and efficient delivery of health care and human services programs. Our client has multiple lines of bu More...

Job Description SummaryThe Computational Data and Sciences graduate Program Coordinator provides a broad range of administrative services to support and manage the daily operations of the computational and data science graduate programs in the Schmid College of Science & Technolog More...

The Clinical Appeals Specialist is responsible for managing client medical necessity denials for multiple service lines (Eating Disorder Treatment Substance Abuse Treatment and Mental Health Treatment) by conducting acomprehensive analytic review of clinical documentation to determine More...

The Appeals Support Representative role directly supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.This is a fulltime remote position that will work Monday through Friday 8:00am4:30pm EST or 8:305:00 More...

The Clinical Appeals Specialist is responsible for managing client medical necessity denials for multiple service lines (Eating Disorder Treatment Substance Abuse Treatment and Mental Health Treatment) by conducting acomprehensive analytic review of clinical documentation to determine More...

At Amazon we believe that every day is still day one. We are working to be the most customercentric company on earth. To get there we need exceptionally talented bright and driven people. If youd like to help the Disability Leave Services (DLS) team build a bestinclass professional s More...

The Utilization Review Case Manager requires effective communication and coordination with the Director of Utilization Review insurance companies and treatment team to obtain the maximum benefits for our clients.  The Utilization Review Case Manager will submit accurate utilizati More...

The Appeals Support Representative role directly supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.This is a fulltime remote position that will work Monday through Friday 8:00am4:30pm EST or 8:305:00 More...

The Clinical Appeals Specialist is responsible for managing client medical necessity denials for multiple service lines (Eating Disorder Treatment Substance Abuse Treatment and Mental Health Treatment) by conducting acomprehensive analytic review of clinical documentation to determine More...

Job SummaryAbout the RoleAlto Pharmacists work crossfunctionally across operations engineering and design teams to build a better more intuitive community pharmacy from the ground up. We focus on challenges that patients providers and payers face and find solutions that optimize exper More...

OverviewAmTrust Financial Services a fast growing commercial insurance company has a need for a Medical Case Manager RN.PRIMARY PURPOSE:To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the i More...

Job SummaryAbout the RoleAlto Pharmacists work crossfunctionally across operations engineering and design teams to build a better more intuitive community pharmacy from the ground up. We focus on challenges that patients providers and payers face and find solutions that optimize exper More...