Utilization Management jobs in California

Epic Tapestry Utilization Management Analyst

Remote

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19d ago

This is 3 months contract with possibility of extention. You can work part time as well (20 hours/week)Position SummaryWe are seeking an experienced Epic Tapestry Utilization Management Analyst to support the design, configuration, build, testing, and implementation of Appeals and Grievances workflows within a healthcare insurance environment. The consultant will work closely with utilization management, appeals and grievances operations, compliance, business, and technical stakeholders to trans

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Third Party, Contract

Depends on Experience

Applied Behavior Analysis / ABA (Utilization Management)

Remote

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5d ago

Active BCBA (Board Certified Behavior Analyst) certification and state licensure (3+ years of ABA (Applied Behavior Analysis) clinical experience - Required Experience creating and supervising ABA (Applied Behavior Analysis) treatment plans Direct patient care background (dealing with children with Behavior / Autism issues) Utilization Management or insurance review experience strongly preferred Comfortable reviewing medical necessity and authorization requests Familiar with managed care and pay

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Contract

Depends on Experience

Medical Director

Remote

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20d ago

Medical Director (Utilization Management) - Remote, USLocation: Remote (US) Employment Type: Contract-to-Hire Schedule: Full-time, 40 hours/week <>About the RoleWe are seeking an experienced Medical Director to join a physician-led team responsible for utilization management and clinical review activities for a health insurance organization. This role focuses on evaluating medical necessity, appropriateness of care, appeals, and complex case reviews while ensuring compliance with applicable regu

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Contract

180 - 200

Senior Director of Academic Technology and Design Services (Remote)

Remote or Columbia, Missouri

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Today

Hiring Department University of Missouri Academic Technology This recruitment is managed by the Office of Human Resources at the Columbia Campus. For application questions please contact OHR at . Job Description University of Missouri Academic Technology is seeking a Senior Director of Academic Technology (AT) and Design Services (DS) to provide bold, visionary leadership for our system-wide academic technology ecosystem and online design and media services for the Columbia campus. This lead

Full-time

USD 125,000.00 - 150,000.00 per year

Data Analyst, Value-Based Care Analytics

Remote

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Today

Counterpart Health is an AI-powered physician enablement platform that delivers clinical insights to providers at the point of care. Our flagship product, Counterpart Assistant, is embedded into clinicians' workflows and integrates with EHR systems, helping care teams drive value-based outcomes, close care gaps, and proactively manage chronic disease. As we expand across Medicare Advantage and other value-based care programs, we need analytical talent that can translate complex clinical and fina

Full-time

USD 96,000.00 - 125,000.00 per year

Sr. Manager, AI/ML Engineering - Remote

Remote or Minnetonka, Minnesota

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Today

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. UnitedHealthcare is accelerating its next-generation AI transformation through Claims AI 10.0 and Ente

Full-time

USD 148,900.00 - 255,300.00 per year

Staff Engineer - ML Operations - USA Remote

Remote

•

Today

Bring more to life. At Danaher, our work saves lives. And each of us plays a part. Fueled by our culture of continuous improvement, we turn ideas into impact - innovating at the speed of life. Our 60,000+ associates work across the globe at more than 15 unique businesses within life sciences, diagnostics, and biotechnology. Are you ready to accelerate your potential and make a real difference? At Danaher, you can build an incredible career at a leading science and technology company, where we're

Full-time

USD 180,000.00 - 220,000.00 per year

Forward Deployed Engineer (FDE) - Remote

Remote

•

Today

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Forward Deployed E

Full-time

USD 203,200.00 - 348,400.00 per year

Forward Deployed Engineer - FDE - Remote

Remote

•

Today

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care's most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together. The Forward De

Full-time

USD 120,100.00 - 214,500.00 per year

Director, Payer Technology Optum Advisory - Remote

Remote or Eden Prairie, Minnesota

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Today

Full-time

USD 134,600.00 - 230,800.00 per year

Senior Engineering Technician

San Francisco, California

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Today

Fresh Consulting is a design-led, software development and hardware engineering company, offering end-to-end digital services to help companies innovate. We bring together amazing UX designers, sophisticated developers, digital strategists, and top-notch engineers to help companies create fresh experiences that connect humans, systems, and machines. We've been growing fast and need someone to help us continue to manage the delivery of high-quality work in a fast-paced environment. See more at fr

Full-time

USD 40.00 - 50.00 per hour

Principal Engineer -- Salesforce Architect (Health Cloud)

Remote

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Today

Company Description We are a Digital Product Engineering company that is scaling in a big way! We build products, services, and experiences that inspire, excite, and delight. We work at scale - across all devices and digital mediums, and our people exist everywhere in the world (18000+ experts across 37 countries, to be exact). Our work culture is dynamic and non-hierarchical. We are looking for great new colleagues. That is where you come in! Job Description Lead end-to-end Salesforce Health

Full-time

Associate Principal Engineer -- Salesforce Architect (Health Cloud)

Remote

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Today

Full-time

Principal Engineer -- Salesforce Architect

Remote or Atlanta, Georgia

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Today

Company Description We are a Digital Product Engineering company that is scaling in a big way! We build products, services, and experiences that inspire, excite, and delight. We work at scale - across all devices and digital mediums, and our people exist everywhere in the world (18000+ experts across 28 countries, to be exact). Our work culture is dynamic and non-hierarchical. We are looking for great new colleagues. That is where you come in! Job Description Lead end-to-end Salesforce Health

Full-time

EPIC Application Coordinator - Sr

Pasadena, California

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Today

Job#: 3046098 Job Description: EPIC Application Coordinator - Sr Location: Fully Remote Role Overview We are seeking a senior-level EPIC Application Coordinator. This role is responsible for making system configuration changes in the Epic application, translating business requirements into software specifications, and acting as a liaison for configuration issues. The position involves in-depth analysis of workflows, data collection, and other technical aspects associated with the Epic softwa

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Full-time

$90 - $110 per hour

Lead, Medicaid Technology

Remote or Oklahoma

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Today

Become a part of our caring community The Lead for Medicaid Technology is responsible for driving end-to-end technology delivery for Medicaid initiatives. This role ensures successful implementation of use cases across multiple horizontal platform owners, aligning with regulatory requirements and enterprise architecture standards. The leader will serve as the primary technology point of contact for Medicaid, orchestrating cross-functional collaboration to deliver compliant, scalable, and innovat

Full-time

USD 117,600.00 - 161,700.00 per year

Authorizations and Claims Analytics Solutions and Data Analyst III

Los Angeles, California

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Today

Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality he

Full-time

USD 102,183.00 per year

Senior Data Extraction Specialist

Temecula, California

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Today

Why We Are - Who We Are: About Enterprises What We Do - ;br> Position Summary The Senior Data Extraction Specialist is responsible for reviewing clinical documentation and accurately extracting and translating pertinent clinical findings into structured data within the InCircle application. This role directly supports the integrity, accuracy, and timeliness of data inputs that drive clinical review workflows and downstream operational processes. Operating within defined guidelines and data sta

Full-time

USD 68,000.00 per year

Principal AI Program Manager, Appeals Innovation and Automation - Remote

Remote or Cypress, California

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Today

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Principal AI Program Manager will lead the identification, governance, development, implementation

Full-time

USD 91,700.00 - 163,700.00 per year

Senior Engineer, Big Data - Claims Reporting Analytics - Remote

Remote

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Today

Job Description Job Summary Responsible for all the aspects of architecture, design and implementation of Data Management solution using Big Data platform on Cloudera or Hortonworks and other areas of enterprise application platforms. Reporting and analytics are very important for this position. Payment integrity is also important. Please update your resume with any relevant previous experience. Knowledge/Skills/Abilities Designs and builds enterprise data solutions on Microsoft Azure (Azure Da

Full-time

USD 79,607.91 - 172,483.80 per year

Utilization Management jobs in California, USA