Grievance and Appeals Nurse Specialist (LVN or RN) Kinetic Personnel GroupGrievance and Appeals Nurse Specialist (LVN or RN)Orange, CA$43–$65 / hourTemporaryUtilize computer and appropriate software (e.g., Microsoft Office: Excel, Outlook, PowerPoint, Word) and job-specific applications/systems to produce correspondence, charts, spreadsheets and/or other information applicable to the position assignment. A permanent position does include excellent CalPERS pension, 401a (4% contribution) and excellent government benefits and Holiday/PTO schedule.
Clinical Reviewer-SCA Acentra HealthClinical Reviewer-SCACA$28.37–$39.19 / hourFor non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Clinical Reviewer, Radiation Therapy ( WEST COAST HOURS) Evolent Health IncClinical Reviewer, Radiation Therapy ( WEST COAST HOURS)CA$38–$39 / hourTechnical Requirements: We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Clinical Reviewer Iconma LLCClinical ReviewerCAAssesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department. Our Client, a Leading Provider of Healthcare Delivery Systems and Solutions company, is looking for a Clinical Reviewer for their Remote/CA location.
(US) Clinical Reviewer (Surgeon/SME, Part-Time / Contract) - USA Codvo.ai(US) Clinical Reviewer (Surgeon/SME, Part-Time / Contract) - USAMaharashtra, CaliforniaMission: Ensure clinical validity of ontology/guidelines and sign off on golden sets and edge-case adjudications. Board-certified clinician or domain SME with relevant specialty experience; comfortable reviewing video clips efficiently.
Clinical Quality Reviewer - BCBA Onos HealthClinical Quality Reviewer - BCBASan Francisco, CaliforniaThe ideal candidate is detail-oriented with strong applied clinical knowledge and an interest in improving outcomes in autism/ABA services, enabling data-driven decision making, developing operational efficiencies, and AI-enabled healthcare solutions. In this role, you’ll report directly to our Senior Vice President of Clinical Operations and work alongside the clinical and product teams to validate system outputs, support enhancements, and make modifications to our platform.
Physician Reviewer Internal Medicine-Field Medical Director, Radiology (Part Time) Evolent Health IncPhysician Reviewer Internal Medicine-Field Medical Director, Radiology (Part Time)CA$95–$100 / hourNot under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. What You Will Be Doing: Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.
Otolaryngologist-Physician Reviewer-Field Medical Director, Radiology (Full-Time) Evolent Health IncOtolaryngologist-Physician Reviewer-Field Medical Director, Radiology (Full-Time)CA$95–$109 / hourNot under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. What You Will Be Doing: Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.
Endocrinology-Physician Reviewer-Field Medical Director, Radiology (Full-Time) Evolent Health IncEndocrinology-Physician Reviewer-Field Medical Director, Radiology (Full-Time)CA$95–$109 / hourNot under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. What You Will Be Doing: Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.
Rheumatologist-Physician Reviewer-Radiology (Full-Time) Evolent Health IncRheumatologist-Physician Reviewer-Radiology (Full-Time)CA$95–$109 / hourNot under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. What You Will Be Doing: Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.
RN Reviewer Cohere Health Technologies LLCRN ReviewerCARemote$2,022–$2,025Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes. You will work closely with Medical Directors and other Cohere Health staff to ensure appropriate cost-effective care by applying your clinical knowledge and critical thinking skills to assess the medical necessity of inpatient admissions, outpatient services and procedures, and provider out of network requests.
PM&R -Independent Medical Reviewer Managed Medical Review OrganizationPM&R -Independent Medical ReviewerCAManaged Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide. We are currently seeking Board-Certified Physical Medicine & Rehabilitation Physicians to join our network of sub-contracted Physician Reviewers.
NewQC Reviewer Integrated Resources, IncQC ReviewerSan Diego, CaliforniaContractorThis is Direct Hire with our ClientJob DescriptionOur client is looking for "QC Reviewer" with strong expertise in "Clinical Trials" and "Clinical Knowledge"• The successful candidate will have the ability to integrate information from the clinical database to ensure high quality data that enables appropriate analyses for successful regulatory submissions of oncology compounds.• The ability to work independently to think through results, resolve data discrepancies, be able to comb through long data dense documents, analyze, interpret and apply new clinical data with a focus on the key messages is essential.•
Medical Writer / Medical Reviewer Consultant - Oncology Ovarian Cancer ClinChoice IncMedical Writer / Medical Reviewer Consultant - Oncology Ovarian CancerCARemoteThe successful candidate will collaborate with Medical Affairs, Clinical Development, Regulatory Affairs, Biostatistics, and external experts to ensure scientific accuracy, compliance, and timely execution of deliverables. We are seeking an experienced Medical Writer or Medical Reviewer with expertise in Ovarian Cancer and Gynecologic Oncology to support the development, review, and delivery of high-quality scientific and medical content.
Psychologist Reviewer Centene Corporation GroupPsychologist ReviewerCARemote$87,700–$157,800 / yearPosition Purpose: Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care. For ABA Reviewers only, working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices designed for individuals with Autism Spectrum Disorder.
Data Reviewer, Quality Control Avid Bioservices IncData Reviewer, Quality ControlTustin, CA$31.63–$42.16 / hourIn this role you will: Conduct a comprehensive and critical evaluation on QC data in Empower and SoftMax Pro software including but not limited to contents, results, data accuracy, and scientific relevance, format and adherence to cGMPs. Physical Demands & Work Environment: In this dynamic role, expect a blend of regular activities like sitting, standing, and walking, with occasional physically engaging tasks such as lifting objects up to 20 pounds.
Psychologist Reviewer - ABA Elevance Health IncPsychologist Reviewer - ABAWoodland Hills, CA$93,120–$167,616 / yearOutpatient levels of care include: Individual Therapy, Group Therapy, Family Therapy, Marriage/Couples Therapy, Psychological Testing, Neuropsychological Testing, Psychosocial Rehabilitation, Intensive Outpatient Treatment, Day Treatment, Mental Health Support Services, Applied Behavioral Analysis, and Autism Spectrum Disorder Services. • Mentors Behavioral Health Care Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives; assists in developing a program around psychological and neuropsychological testing.
NewHealthcare Compliance Trainer & Regulatory Site Reviewer (DHCS Certified Master Trainer) Macpower Digital Assets Edge Private LimitedHealthcare Compliance Trainer & Regulatory Site Reviewer (DHCS Certified Master Trainer)Pleasanton, CA$180,000–$256,000 / yearAbout the Role: We're looking for a certified healthcare compliance professional to lead quality reviews and ensure our facilities meet all state and federal regulations. Compliance Leadership Perform state-required facility surveys (FSR/MRR/PAR).
Research Charge Reviewer - Hematology/Oncology University of CaliforniaResearch Charge Reviewer - Hematology/OncologyLos Angeles, CA$36.79–$55.78 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. Given the complexity and volume of clinical trial protocols, this role requires strong expertise, attention to detail, and the ability to effectively manage and execute billing requirements across multiple studies.
Peer Reviewer (Subcontractor) Acentra HealthPeer Reviewer (Subcontractor)CAIn fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. We are also seeking Physicians with OB experience who render care to obstetric patients (prenatal care as well as labor and delivery care) with a minimum of 5 years' experience in an outpatient setting.
Psychologist Reviewer - ABA Elevance HealthPsychologist Reviewer - ABAWoodland Hills, CaliforniaOutpatient levels of care include: Individual Therapy, Group Therapy, Family Therapy, Marriage/Couples Therapy, Psychological Testing, Neuropsychological Testing, Psychosocial Rehabilitation, Intensive Outpatient Treatment, Day Treatment, Mental Health Support Services, Applied Behavioral Analysis, and Autism Spectrum Disorder Services. Mentors Behavioral Health Care Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives; assists in developing a program around psychological and neurops Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.
UM Nurse Reviewer Astiva Health, Inc.UM Nurse ReviewerOrange, CA$75,000–$95,000 / yearSUMMARY: The Utilization Management Authorization Review Nurse is responsible for managing inpatient & outpatient utilization by conducting thorough reviews of clinical documentation and applying clinical knowledge in accordance with relevant Care Guidelines and CMS regulations. This policy relates to all phases of employment, including but not limited to recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company sponsored employee activities.
Research Charge Reviewer - HematologyOncology UCLA Health SystemResearch Charge Reviewer - HematologyOncologyLos Angeles, CA$36.79–$55.78 / hourb'nn n n n n n n n n n n n nn n n n n n n n n n n n n n n n n n Research Charge Reviewer - Hematology/Oncology - - 30678 - UCLA Healthn n nnnn nn n n n nn n n n n Skip to content nn n n n n n UCLA Health Home Page n n nn nnn n nn n Main menu. Press enter or space keys to expands and escape key to collapse nn n n n n n n Searc...
QC Analyst II/III Reviewer (Contract) Adverum Biotechnologies IncQC Analyst II/III Reviewer (Contract)Redwood City, CA$40–$50 / hourAs a vital member of the Quality Control unit, the analyst will play a significant role in advancing and performing Quality Control (QC) review of different assay techniques, systems, policies, processes, procedures, and controls pertinent to the analytical examination of clinical materials. Leveraging the research capabilities of its proprietary intravitreal (IVT) platform, Adverum is developing durable, single-administration therapies designed to be delivered in physicians' offices to eliminate the need for frequent ocular injections to treat these diseases.
Medical Reviewer, Physician Assistant Cohere Health Technologies LLCMedical Reviewer, Physician AssistantCARemote$120,000–$135,000 / yearBy 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. Reporting to the Managing Medical Director MSK Spine and Ortho for Cohere Health, and part of the review team that includes non-clinical intake specialists, nurses and physicians, this is a critical role in a Series B company that is rapidly scaling to impact millions of patients.
DRG Clinical Validation Lead Elevance Health IncDRG Clinical Validation LeadWalnut Creek, CA$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Utilization Management Clinical Trainer (Hybrid Remote) Alignment Healthcare IncUtilization Management Clinical Trainer (Hybrid Remote)CARemote$77,905–$116,858 / yearThis position builds and maintains strong collaborative partnerships with key partners in the Clinical Services organization including Care Management, Performance Improvement, Medical Management and Policy including Quality and Medical Review and Appeals, Pharmacy, and Provider Integration to identify, develop, implement, and monitor performance metrics related to UM Operations. Job Requirements: Experience: Minimum of 5 years nursing experience in managed care, utilization review, case management, quality improvement, or acute care nursing-particularly roles involving interdisciplinary coordination, clinical documentation review, or patient discharge planning.
Clinical Quality Oversight Nurse Wollborg Michelson RecruitingClinical Quality Oversight NurseOakland, CAThe Clinical Quality Reviewer investigates and evaluates potential quality of care issues (PQIs) arising from member grievances and internal referrals. The reviewer conducts case reviews according to department protocols, coordinates appropriate levels of review, and executes follow-up actions.
Registered Nurse Centralized Clinical Operations (CCO) DAP Health IncRegistered Nurse Centralized Clinical Operations (CCO)Palm Springs, CAThis position partners closely with clinicians, nursing leadership, and Risk & Quality teams to support accurate documentation, adherence to Health Resources and Services Administration and Federal Tort Claims Act requirements, and consistent execution of in-basket workflows. This role serves as a critical safety and access point by ensuring appropriate clinical oversight, prioritization, escalation, and resolution of in-basket communications, including test results, patient messages, prescription refill requests, and other clinical tasks.
Clinical Effectiveness Consultant III Sutter HealthClinical Effectiveness Consultant IIISan Francisco, CAAssists in the development of an organization wide performance improvement plan (supplementary to the corporate performance improvement requirements) which integrates the medical staff / medical group structure and activities, and in the development of long-term strategies and methodologies for evaluation of processes and outcomes across the continuum of care including measurement, analysis, and reporting of data used in achieving goals identified in the strategic plan. Clinical Laboratory Technologist, Diagnostic Medical Sonographer, Medical Dosimetrist, Biomedical Engineer/Bioengineer, Bioinformatics/Biostatistician Specialist, Blood Bank Technologist, Cytotechnologist, Radiation Therapist, Forensic Science Technician, or Registered Health Information Technician).
Licensed Clinical Social Worker Sutter HealthLicensed Clinical Social WorkerSanta Rosa, CA$48.80–$65.59 / hourTotal compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Position Overview: The Licensed Clinical Social Worker (LCSW) provides crisis intervention, information, referrals, and discharge planning for patients and their families, ranging in age from infancy to geriatrics.
Lead Clinical Research Associate PSI CRO AGLead Clinical Research AssociateCAThis role focuses on leadership, mentorship, oversight, and consistency in monitoring practices rather than direct site management, with minimal to no site assignments and a low-travel model, emphasizing remote oversight and overall study quality. As a Lead Clinical Research Associate, you will hold a leadership role within the study team, overseeing and guiding the clinical team while driving trial activities at a country or regional level.
NewClinical Network Compliance Auditor, Supervisor SHPCA SCAN Health PlanClinical Network Compliance Auditor, SupervisorLong Beach, CaliforniaHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. Performs and provides oversight to the Managed Care Plan's (MCP) Department of Health Care Services (DHCS) auditing team responsible for conducting and overseeing both initial and subsequent reviews of Primary Care Provider (PCP) sites.
NewClinical Documentation Improvement Specialist Sharp HealthCareClinical Documentation Improvement SpecialistSan Diego, CA$57.74–$74.49 / hourCommunication and teamworkDemonstrates positive interpersonal relations in dealing with all members of the team (i.e. co-workers, supervisors, physicians, etc.) as evidenced by: communicating in a positive and productive manner; demonstrating respect for team members; maintaining a positive attitude; about assignments and team members; and working collaboratively; and cooperating with other departments/units. DocumentationImproves accuracy documentation specificity and completeness with real-time interactive communication and education of physicians, clinicians, and other involved parties regarding the necessity of providing complete and clear documentation of the care provided throughout a patient's stay.
Manager Clinical Data and Reporting Standards - SDTM Programming Hybrid AbbVie IncManager Clinical Data and Reporting Standards - SDTM Programming HybridIrvine, CAApplicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law: The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole and absolute discretion unless and until paid and may be modified at the Company's sole and absolute discretion, consistent with applicable law.
NewAssociate Director, Clinical Data Management Revolution MedicinesAssociate Director, Clinical Data ManagementRedwood City, CaliforniaThe company’s RAS(ON) inhibitors daraxonrasib (RMC-6236), a RAS(ON) multi-selective inhibitor; elironrasib (RMC-6291), a RAS(ON) G12C-selective inhibitor; zoldonrasib (RMC-9805), a RAS(ON) G12D-selective inhibitor; and RMC-5127, a RAS(ON) G12V-selective inhibitor, are currently in clinical development. Provides CDM oversight of outsourced and partner-resourced clinical trials including scoping trials, project management, relationship management, approval of deliverables, and coordination of internal reviewers.
Director, Clinical Data Management Revolution MedicinesDirector, Clinical Data ManagementRedwood City, CaliforniaThe company’s RAS(ON) inhibitors daraxonrasib (RMC-6236), a RAS(ON) multi-selective inhibitor; elironrasib (RMC-6291), a RAS(ON) G12C-selective inhibitor; zoldonrasib (RMC-9805), a RAS(ON) G12D-selective inhibitor; and RMC-5127, a RAS(ON) G12V-selective inhibitor, are currently in clinical development. Provides CDM oversight of outsourced and partner-resourced clinical trials including scoping trials, project management, relationship management, approval of deliverables, and coordination of internal reviewers.
Director, Clinical Data Management Revolution Medicines IncDirector, Clinical Data ManagementRedwood City, CA$211,000–$264,000 / yearThe company's RAS(ON) inhibitors daraxonrasib (RMC-6236), a RAS(ON) multi-selective inhibitor; elironrasib (RMC-6291), a RAS(ON) G12C-selective inhibitor; zoldonrasib (RMC-9805), a RAS(ON) G12D-selective inhibitor; and RMC-5127, a RAS(ON) G12V-selective inhibitor, are currently in clinical development. Provides CDM oversight of outsourced and partner-resourced clinical trials including scoping trials, project management, relationship management, approval of deliverables, and coordination of internal reviewers.
NewAssociate Director, Clinical Data Management Revolution Medicines IncAssociate Director, Clinical Data ManagementRedwood City, CA$186,000–$233,000 / yearThe company's RAS(ON) inhibitors daraxonrasib (RMC-6236), a RAS(ON) multi-selective inhibitor; elironrasib (RMC-6291), a RAS(ON) G12C-selective inhibitor; zoldonrasib (RMC-9805), a RAS(ON) G12D-selective inhibitor; and RMC-5127, a RAS(ON) G12V-selective inhibitor, are currently in clinical development. Provides CDM oversight of outsourced and partner-resourced clinical trials including scoping trials, project management, relationship management, approval of deliverables, and coordination of internal reviewers.
Per Diem Clinical UR Specialist Kaweah Delta Health Care District GuildPer Diem Clinical UR SpecialistVisalia, CA$30.17–$45.26 / hourPerforms Utilization Management to meet Case Management Goals: Reviews and records utilization review data to determine medical necessity for assigned caseload in a manner to ensure all inpatient records are current. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics.
Clinical UR Specialist Kaweah Delta Health Care District GuildClinical UR SpecialistVisalia, CA$30.17–$45.26 / hourPerforms Utilization Management to meet Case Management Goals: Reviews and records utilization review data to determine medical necessity for assigned caseload in a manner to ensure all inpatient records are current. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics.
Principal Clinical Content- Physician - UpToDate®, Physician Editor, Adult Neurology Wolters Kluwer N.V.Principal Clinical Content- Physician - UpToDate®, Physician Editor, Adult NeurologyCA$173,500–$310,000 / yearUpToDate editors work closely with outside authors, section editors, editors-in-chief, and peer reviewers to ensure the material is accurate and free of bias. In the remaining 10 to 20% time, Physician Editors should continue patient care activities, using their clinical experience to help ensure the content of the program is maximally useful at the point of care.
Quality Assurance / Clinical Oversight, Voice AI Product RadiantGraphQuality Assurance / Clinical Oversight, Voice AI ProductSan Francisco, CaliforniaThe platform delivers measurable improvements in enrollment, care-gap closure, and ROI — with results in weeks, not quarters — supporting enterprise payers, digital health organizations, and care delivery partners working to improve outcomes and reduce total cost of care. Its AI-powered platform unifies claims, pharmacy, clinical, and SDoH data into a single intelligence layer, applies proprietary machine learning to identify high-impact member cohorts, and drives personalized outreach across all channels, including voice AI.
NewManager, Clinical Quality System Documents Arrowhead PharmaceuticalsManager, Clinical Quality System DocumentsLos Angeles, CA$120,000–$145,000 / yearLead and coordinate document activities with cross-functional business stakeholders, including Clinical Operations, Drug Safety/Pharmacovigilance, Biometrics, Clinical Data Management, Clinical Development/Medical, Regulatory Affairs, Medical Writing, Clinical Supply Management and Clinical Quality Assurance, ensuring timely completion of document deliverables. Support QMS Quality Assurance (QA) counterparts in executing document control workflows by coordinating and facilitating the development, review, revision, approval, issuance, periodic review, and retirement of controlled documents across Clinical Development functions, ensuring timely completion and compliance with established document control processes.
Manager, Clinical Quality System Documents Arrowhead Pharmaceuticals IncManager, Clinical Quality System DocumentsSan Diego, CA$120,000–$145,000 / yearLead and coordinate document activities with cross-functional business stakeholders, including Clinical Operations, Drug Safety/Pharmacovigilance, Biometrics, Clinical Data Management, Clinical Development/Medical, Regulatory Affairs, Medical Writing, Clinical Supply Management and Clinical Quality Assurance, ensuring timely completion of document deliverables. Support QMS Quality Assurance (QA) counterparts in executing document control workflows by coordinating and facilitating the development, review, revision, approval, issuance, periodic review, and retirement of controlled documents across Clinical Development functions, ensuring timely completion and compliance with established document control processes.
Director, Clinical Quality Assurance CQA Coherus Oncology IncDirector, Clinical Quality Assurance CQARedwood City, CA$190,000–$240,000 / yearThe position will also be responsible for supporting and hosting regulatory inspections and defining and implementing clinical compliance plans to include GCP/GCLP/GVP audits of service providers, CROs, investigator sites, bioanalytical laboratories, and Drug Safety and Pharmacovigilance systems and processes. This role is responsible for ensuring that Coherus plans and systems that govern clinical studies are in compliance with regulatory requirements, industry best practices (ie GCP, GLP, GVP) and company SOPs by working with Quality management, external auditors, and other internal Clinical functions.
Clinical Documentation Improvement Specialist Sharp Health PlanClinical Documentation Improvement SpecialistSan Diego, CA$57.74–$74.49 / hourDemonstrates positive interpersonal relations in dealing with all members of the team (i.e. co-workers, supervisors, physicians, etc.) as evidenced by: communicating in a positive and productive manner; demonstrating respect for team members; maintaining a positive attitude; about assignments and team members; and working collaboratively; and cooperating with other departments/units. Improves accuracy documentation specificity and completeness with real-time interactive communication and education of physicians, clinicians, and other involved parties regarding the necessity of providing complete and clear documentation of the care provided throughout a patient's stay.
NewSr Specialist Bariatric Process Improvement- Sharp Coronado (Virtual- CA residents only) - Per Diem - Days Sharp Health PlanSr Specialist Bariatric Process Improvement- Sharp Coronado (Virtual- CA residents only) - Per Diem - DaysCA$58.92–$76.03 / hourThe actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. The Bariatric Surgery Clinical Reviewer will support the Bariatric Surgery Department by collecting and submitting reliable data to the American College of Surgeons Bariatric Data Registry Platform.
Rheumatologist (actively practicing) for remote PRN peer reviews DOMA TechnologiesRheumatologist (actively practicing) for remote PRN peer reviewsCARemote$750–$2,000We're growing our network of clinical reviewers and are actively seeking Rheumatologists (must be actively practicing) who are passionate about quality, accountability, and patient outcomes. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.
Medical Director - Medicare Advantage Blue Cross and Blue Shield AssociationMedical Director - Medicare AdvantageLos Angeles, CANecessary Contacts: department Managers, Authorization, Utilization Management, Case Management, Disease Management, Compliance personnel, and other employees as indicated, Licensed Doctors of Medicine (Physicians), Hospitals, and other healthcare providers, Parish and state medical agencies and societies as needed, Accreditation and governmental entities' personnel as needed. Fulfills medical director duties as appropriate which include but are not limited to: peer reviews, case reviews, completion of inter-rater reliability case reviews annually, active participation in training activities, provision of documentation to support compliance with annual licensure requirements, claims review to determine proper resolution, maintaining a working knowledge of company policies and procedures.