Nurse UM Denial Compliance Supervisor
$110kRegal Medical Group
A leading healthcare organization in Los Angeles seeks a Nurse Clinical Supervisor to oversee the denial process within the utilization management department. The role includes supervising unit staff, collaborating on denial decisions with medical professionals, and ensuring compliance with regulatory standards. The position offers a competitive starting salary of $110,000, depending on experience, along with a sign-on bonus and comprehensive benefits such as employer-paid health coverage and 401(k) plans. #J-18808-Ljbffr Regal Medical Group
- University of California - Los Angeles Health is seeking an UM Denial Nurse Reviewer to support cost-effective care by applying clinical... ...Medical Directors, and leadership to clarify cases and maintain compliance with DMHC, CMS, HIPAA, and NCQA requirements. #J-18808-...Suggested
- UCLA Outpatient Clinics in Los Angeles is seeking a UM Denial Nurse Reviewer to apply clinical knowledge, policies, and regulatory guidelines to review adverse determinations and ensure accurate, timely notifications. The role involves reviewing denials for proper documentation...Suggested
- ...Job Description Job Description POSITION SUMMARY The Accreditation Compliance Supervisor is essential in ensuring Tarzana Treatment Centers College (TTCC) meets and maintains all accreditation standards. This position oversees the entire accreditation process, including...SuggestedWork at office
$145k - $175k
...Estimated Start Date: 11/30/26 Role Scope: The Habitat Health Compliance Manager has oversight for ensuring the successful outcome of... ...audit or related field. Active and unrestricted Registered Nurse (RN) License. Experience in PACE compliance highly preferred...SuggestedContract workTemporary workFixed term contractLocal areaRemote workFlexible hours$30 - $34 per hour
...Center Dr., Monterey Park, CA 91754 Compensation: $30.00 - $34.00 / hour Department: Health Services (HS - UM) Job Title Utilization Management Review Nurse About the Role Astrana Health is looking for a Utilization Review Nurse to assist our Health Services Department...SuggestedHourly payWork at officeMonday to FridayShift work$65.8k - $130.8k
Description The UM Denial Nurse Reviewer supports high-quality, cost-effective care by applying clinical knowledge, policies, and regulatory... ...criteria/guidelines, benefit policies, and regulatory compliance. Apply clinical knowledge and the appropriate clinical review...- ...Description Job Description Job Description: Clinical Supervisor, UM Denial Compliance Location: Los Angeles Metropolitan Area Position... ...Qualifications: 1. Graduate from an accredited Registered Nursing Program; RN preferred. 2. Minimum of five years in...Permanent employmentTemporary workRemote work
$30.37 - $59.21 per hour
...optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines... .... • Adheres to utilization management (UM) policies and procedures. Required... ...relevant education and experience. • Registered Nurse (RN). License must be active and...Hourly payWork experience placementWork at officeRemote work- ...and coordinating care to ensure medical necessity and benefit compliance. The selected candidate will use advanced clinical judgment and... .... Required Qualifications Graduate of an accredited nursing program (ASN, ADN, BSN, or MSN). Bachelors preferred. Advanced...
$150k - $170k
...application process. Director, UM - RN Full Time Pasadena,... ...referrals requests in compliance with Federal, State, Health Plan... ...communication and relations with Supervisor, co-workers and other staff.... .../TRAINING ~ Registered Nurse (RN) in the State of California...Full timeLocal area$80k - $120k
...Description The Role We are seeking an organized and detail-oriented Retirement Plan Compliance Analyst to join our team. As a compliance analyst you will play a crucial role in supporting our attorneys by performing a variety of tasks, which will include drafting...Temporary workWork at officeLocal areaVisa sponsorshipWork visaFlexible hours$25 - $30 per hour
...M & F Laundry is growing, and we're looking for a Safety & Compliance Manager to help us continue building a safer, stronger and more... ...root causes Confident communicating with employees, supervisors and senior management Capable of turning regulations into...Hourly payFull timeLocal area$210k - $240k
...regulatory requirements, noting deviations and inconsistencies.Strong knowledge of document formatting (MS Word documents, PDFs compliance, and validation tools)Ability to maintain highest degree of professionalism, integrity and diplomacyPreferredExperience with regulatory...$143.23k - $185.35k
We’re here for one reason and one reason only - to cure cancer. Every moment is dedicated to developing treatments and every action moves us one step closer to our goal. We’ve made incredible scientific breakthroughs and our pioneering personalized CAR T-cell therapies ...Full timeFor contractorsWork at officeLocal areaRemote workRelocationFlexible hoursShift work- ...facilities.Maintain accurate regulatory records and documentation in relevant systems related to LVV manufacturing, supply, regulatory compliance, and health authority commitmentsIdentify and escalate risks and contribute to mitigation strategies focused on evolving global...Full timeContract workFor contractorsWork at officeLocal areaRemote workRelocationFlexible hours
- ...including achievement of timelines and deliverablesEnsure that regulatory documents are accurate, complete and verifiable, and confirm compliance with regulatory requirementsServe as the US Regulatory Lead (USRL) for assigned Regulatory Project Teams in the development of...Full timeFor contractorsWork at officeLocal areaRemote workRelocationFlexible hours
- Join the Clean Energy RevolutionBecome a Senior Manager, Hydroelectric Licensing & Regulatory Compliance at Southern California Edison (SCE) and build a better tomorrow. In this job, you’ll lead the team responsible for Hydropower licensing, regulatory compliance, permitting...Local areaRemote workRelocation
$303k
...inclusive leadership culture centered on Snap’s values of Kind, Smart, and Creative.We’re looking for a Director, Integrity and Compliance to join Snap’s Legal Team! In this role, reporting to the Chief Compliance Officer, you will lead Snap’s global Integrity & Compliance...Full timeLive inWork at officeLocal area$136.1k - $156.7k
Role Overview:If you are an experienced professional looking for an opportunity to help shape and drive our compliance and data privacy strategy, we would like to meet with you!The Senior Manager, Compliance and Privacy, drives the strategic direction of the firm's compliance...Full timeWork at officeLocal areaRemote workRelocation package2 days per week3 days per week$145k - $160k
...therapies to patients in need. The PositionThis position is responsible for supporting multiple global regulatory projects, ensuring compliance with all relevant regulatory requirements and guidelines, and develop and execute regulatory plans. This position will report to...- ...Imperial Health Plan in Pasadena, CA seeks a Director of UM - RN to lead the UM/Prior Authorization and Inpatient Teams. This exempt... ...full-time role reports to the Chief Medical Officer and ensures compliance with regulatory and NCQA standards. Responsibilities include...Full time
$160k - $260k
...achievement of our strategic goalsGenerates sustainable shareholder returns and above market shareholder value#LI-PostJob SkillsAudits Compliance, Critical Thinking, Data Gathering Analysis, Decision Making, Financial Regulation, Industry Knowledge, Interpersonal...Full timeWork at officeFlexible hoursWeekend work$130k - $160k
About the OpportunityThe Senior Manager, Benefits & Compliance is the company’s benefits subject-matter leader responsible for shaping, delivering, and continuously improving a comprehensive benefit and leave experience that supports employees while aligning with business...Full timeContract work- ...Description Job Description PURPOSE: The Prior Authorization Nurse will document and process prior-authorizations for HMO Medi-Cal,... ...history and applying criteria in determining approval or denial decision. Creating deferral letters to obtain medical records...Contract work
$151k - $222.1k
ABOUT THE TEAMThe Sales Compliance team makes sure DoorDash and Deliveroo charge every merchant correctly and sell in a way that is compliant and built to scale. We own sales controls, revenue assurance, and order-to-cash (OTC) controls across the Merchant organization...Hourly payContract workWork at officeLocal areaRemote workFlexible hours- ...SUMMARY The Compliance Manager will play a critical, hands-on role in establishing and managing our company's compliance framework during a pivotal time of transition. This is not a typical corporate role; it is a unique opportunity to build and shape the financial...Local area
$72.3k
...Compliance Manager Apartment Management Consultants (AMC) is a leader in the property management industry. Our passion for helping... ...communicate effectively with others – employees, properties, supervisors, etc. Compensation: Full-Time $ 72,304.00 to $ 72,800....Full timeTemporary workPart timeLocal area$100k - $110k
...benefit our employees and surrounding communities. We are an Equal Opportunity Employer Description of Duties: Title: Compliance Manager Classification: Exempt Salary Range* : $100,000-$110,000 Location: HQ (Van Nuys, CA) Onsite Monday - Friday...Fixed term contractMonday to Friday- ...Compliance Manager The Compliance Manager role will manage the compliance, product safety and regulatory strategy, policies and procedures for Warner Bros Tours and Retail group within the Burbank Hollywood Tour across multiple IPs. The role focuses on product compliance...Full timeLocal areaMonday to Friday
- ...Overview ERP International is seeking a full time Registered Nurse - Case Management in support of the Active Duty wounded and... ...community resources. • Integrate CM and utilization management (UM) and integrating nursing case management with social work case management...Full timeTemporary workWork at officeLocal areaMonday to Friday
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