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Specialist, Lifesaving
1 week ago
Best Friends Animal Society Los Angeles, United StatesLocation: Los Angeles CA · - Position Title: Specialist, Lifesaving and Care · - Hiring Range: This position's hiring range is anticipated to be $21.74 to $24.96 hourly, depending on experience, plus great benefits · - Interviews will occur weekly until the position is filled. · ...
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Shred Specialist
1 day ago
Vital Records Holdings LLC Los Angeles, United States: · **$17-21/hr** · **Shred Specialist** · The Shred Specialist position at Vital Records Control Companies ("VRC") is responsible for receiving, segregating and loading wastepaper into a paper shredder as well as various traditional warehouse support duties. The Shred Specialist ...
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Simulation Specialist
1 week ago
Children's Hospital Los Angeles Los Angeles, United StatesThe **Simulation Specialist **will be responsible for the preparation, operation, and clean-up of all the simulation equipment for courses and scenarios offered at the Las Madrinas Simulation Center. The Simulation specialist will also perform periodic maintenance, repair, and tr ...
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Data Specialist
1 week ago
Brotherhood Crusade Los Angeles, United StatesJob Summary: · The Data Specialist will be required to fully understand the MEL(Monitoring, Evaluation and Learning Protocol) measures, identify inconsistencies in data, assist team members who are measuring and recording participant progress with respect to critical success indi ...
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Learning Specialist
6 days ago
UCLA Los Angeles, United StatesGeffen Academy at UCLA is seeking a Learning Specialist who works closely with educators, parents/caretakers, and administrators to support students with diverse learning needs and ensure all students experience success in their classrooms. Specifically, the Learning Specialist c ...
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Communications Specialist
1 day ago
CEDARS-SINAI Los Angeles, United States**What you will be doing in this role**: · The Communications Specialist supports institutional development, foundation and community engagement efforts through a variety of writing and editing projects, including support for special events. In collaboration with leadership and o ...
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Specialist, Events
5 days ago
Academy of Motion Picture Arts and Sciences Los Angeles, United StatesThe Academy Museum of Motion Pictures furthers the understanding, celebration, and preservation of cinema through inclusive and accessible exhibitions, screenings, programs, and collections. Welcoming visitors from Los Angeles and around the world, the Museum works in active part ...
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Billing Specialist
3 days ago
Lewis Brisbois Bisgaard & Smith LLP Los Angeles, United States**Overview**: · - Lewis Brisbois is seeking a Billing Specialist with legal experience. The Billing Specialist will have excellent communication skills and a high level of professional service to clients, management, attorneys and other staff in order to effectively, efficiently ...
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Project Specialist
1 day ago
USC Los Angeles, United StatesThe University of Southern California (USC), founded in 1880, is located in the heart of downtown L.A. and is the largest private employer in the City of Los Angeles. As an employee of USC, you will be a part of a world-class research university and a member of the "Trojan Family ...
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Outreach Specialist
1 week ago
Watts Healthcare Corporation Los Angeles, United StatesWith over 50 years of service, our goal is to improve the health of the community we serve by creating easier access to quality clinical, preventative, and specialty healthcare services. Watts Healthcare Corporation is deemed by the Bureau of Primary Health Care of the U.S. Depar ...
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Billing Specialist
3 days ago
USA Compression Los Angeles, United StatesJob Locations US-CA-Los Angeles | US-CA-Costa Mesa | US-CA-San Diego | US-CA-San Bernardino | US-CA-San Francisco | US-CA-Sacramento · - ID · - Category- Accounting/Billing/Finance- Position Type- Regular Full-Time**Overview**: · - Lewis Brisbois is seeking a Billing Specialist ...
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Housing Specialist
1 day ago
Project 180 Los Angeles, United States**The Organization** · SSG-Project 180 turns lives around through innovative, wraparound services that keep people out of · institutions and in their communities. Project 180 is a leader in the forensic treatment space, offering · high-quality, specialized treatment programs that ...
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Benefits Specialist
1 week ago
AIDS Healthcare Foundation Los Angeles, United StatesWHO WE ARE: · **AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation** · Does the idea of doing something that really makes a difference in people's lives while being well-compensated intrigue you? Are you looking to work for an organization that encourag ...
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Onboarding Specialist
1 day ago
UCLA Health Los Angeles, United States**Description** · - Under the direction of the Onboarding Supervisor, you will serve as an administrative resource to the new hire or transfer as well as the entire Talent Acquisition and Onboarding Team. As our Onboarding Specialist, you will partner with various departments wit ...
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Publishing Specialist
5 days ago
Cella Los Angeles, United States**Location: Los Angeles, California** · **Job Type: Contract** · **Compensation Range: $ per hour** · We are seeking a detail-oriented and creative **Publishing Specialist** to join our client's team in Los Angeles · As a Publishing Specialist, you will play a crucial role in upd ...
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Procurement Specialist
3 days ago
TANOSHII NC LLC Los Angeles, United States**Responsibilities**: · - Develop and implement procurement strategies to optimize cost efficiency and quality of goods/services · - Source, evaluate, and negotiate with suppliers to ensure timely and cost-effective procurement of materials and services · - Collaborate with inter ...
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IT Support Specialist
1 day ago
Volunteers of America Los Angeles Los Angeles, United StatesAbout Us: · **_VOALA_** · **_Helping Our Most Vulnerable Change Their Life Stories_** · **PAY RATE**: $33.84-$35.62 PER HOUR · **CORPORATE** · Serving those who serve others - Supporting over 120 social service programs with responsive administrative and logístical efforts. · **J ...
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HR Specialist
5 days ago
Vallarta Supermarkets Los Angeles, United States**Title**:Human Resources Specialist · **Classification**:Non-Exempt · **Reports to**:Human Resources Supervisor · The compensation range provided is in compliance with state-specific laws. Factors that may be used to determine your actual rate of pay include your specific skills ...
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Marketing Specialist
1 day ago
Greater Los Angeles Agency on Deafness, Inc Los Angeles, United StatesPosition: Marketing Specialist · Classification: Non-exempt, 100% FTE · Supervisor: Marketing Director · Location: GLAD Headquarters (Los Angeles) · Department: Marketing · **RESPONSIBILITIES** · Under the supervision of the Marketing Director, the Marketing Specialist will: · - ...
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Sourcing Specialist
1 day ago
Avalon Apparel, LLC Los Angeles, United States**Sourcing Specialist** · **What you will do**: · - Plan coordinate and allocate shipping · - Follow up on materials delivery (communicate with overseas & design) · - Production planning (daily communications with vendors / overseas offices). · - Manage WIP and T&A Calendars · - ...
UR Specialist - Los Angeles, United States - Renewal Health Group
Description
Renewal Health Group is currently looking for a UR Specialist for its Treatment ProgramsThe UR Specialist is responsible for working with healthcare providers to help ensure appropriate and consistent administration of plan benefits through collecting clinical information to preauthorize services, assess medical necessity, out of network services, and appropriateness of treatment setting and applying appropriate medical policies, clinical guidelines, plan benefits, and/or scripted algorithms within scope of licensure.
Benefits:
Renewal Health group, offers competitive salaries for all positions.
Regular employees working at least 30 hours per week are eligible for:
Medical, dental, vision, short-term disability, and life insurance.
Reimbursement for licensing fees
Education assistance
Employee referral bonus
Healthcare Flexible spending account with $250 company contribution for Full time employees
Paid vacation, sick leave, 6 paid holidays, jury duty pay
Direct deposit and same-day pay
Employee Assistance Program
401(k) retirement plan with 4% dollar for dollar match to employees who work a minimum of 1,000 hours per fiscal year.
Availability / Schedule :
This is a full time position with remote work flexibility, but must reside somewhere in the Greater Los Angeles area and be able to attend in person meetings and trainings as needed.
Duties and responsibilities
Conducts pre-certification, out of network and appropriateness of treatment setting reviews within scope of licensure by utilizing appropriate medical policies and clinical guidelines in compliance with department guidelines and consistent with the members eligibility, benefits and contract.
Applies clinical knowledge to work with facilities and providers for care coordination.
May access and consult with peer clinical reviewers, Medical Directors and/or delegated clinical reviewers to help ensure medically appropriate, quality, cost effective care throughout the medical management process.
Educates the member about plan benefits and contracted physicians, facilities and healthcare providers.
Refers treatment plans/plan of care to peer clinical reviewers in accordance with established criteria/guidelines and does not issue medical necessity non-certifications.
Qualifications:
1-2 years of clinical or utilization review experience; or any combination of education and experience, which would provide an equivalent background.
substance use
and mental health in a treatment center preferred
Able to maintain a professional manner with staff, clients, and visitors.
Able to work in a fast paced setting, under pressure, and maintain open, and proper communication.
Must be fluent in speaking, reading, and writing English.
Able to write routine reports and correspondence.
Ability to speak effectively before groups of clients or employees of an organization.
Ability to relate harmoniously with staff and clients of diverse ethnic and economic backgrounds
Experience in providing direct services to individuals, families and groups.
Good Computer skills. Ability to navigate an Electronic Health Records System. Kipu experience a plus.
Demonstrate professionalism, and strong boundaries with the clients.
Hiring Requirements:
Hiring is contingent upon completion of
a Background Check, TB test, and clearance on a drug screen and pre-employment physical. Current First Aid and CPR certification or willing to obtain upon hire.
For the mental health and eating disorder programs additional requirements include
receiving DOJ/FBI fingerprint clearance or an exemption and a submission of a signed Criminal Record Statement (LIC 508). Clean Background is required.
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