Top 440 Medical reviewer Jobs in California

Health Care Professional – Utilization Review / First-Level Reviewer
Encompass Health Solutions, Inc. —Los Angeles, CA
- $42 - $45 an hour
- Overtime
- Remote
- LVN
- RN License
- Mid-level
Quick Apply
2d
Medical Content Reviewer - Remote - Nationwide
Vituity —Sacramento, CA
- $60 an hour
- Per diem
- Remote
- Google Workspace
- English
- Mid-level
DHR Reviewer I - Temp
Penumbra —Alameda, CA
- $22 - $32 an hour
- Temporary
- Mid-level
- Office
- High school diploma or GED
- Paid parental leave
- AD&D insurance
7d
Clinical Quality Reviewer - BCBA
Onos Health —San Francisco, CA
- $110,000 - $140,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Analysis skills
- Commuter assistance
- Paid parental leave
Neuropsychologist
Executive Mental Health, Inc —San Jose, CA
- $110,000 - $140,000 a year
- Full-time
- Hybrid work
- Skilled nursing facility
- Doctoral degree
- Doctor of Philosophy
- Health insurance
- 401(k)
Quick Apply
Neuropsychologist
Executive Mental Health, Inc —Stockton, CA
- $110,000 - $140,000 a year
- Full-time
- Hybrid work
- Skilled nursing facility
- Doctoral degree
- Doctor of Philosophy
- Health insurance
- 401(k)
Quick Apply
Neuropsychologist
Executive Mental Health, Inc —Long Beach, CA
- $110,000 - $140,000 a year
- Full-time
- Hybrid work
- Skilled nursing facility
- Doctoral degree
- Doctor of Philosophy
- Health insurance
- 401(k)
Quick Apply
Neuropsychologist
Executive Mental Health, Inc —Glendale, CA
- $110,000 - $140,000 a year
- Full-time
- Hybrid work
- Skilled nursing facility
- Doctoral degree
- Doctor of Philosophy
- Health insurance
- 401(k)
Quick Apply
Family Medicine Physician Focused on Pediatrics
East Valley Community Health Center Inc. —Pomona, CA
- $240,000 - $267,372 a year
- CPR Certification
- Medicine
- BLS Certification
Quick Apply
Social Work Educator
Partners in Care Foundation, Inc. —San Fernando, CA
- $26 - $32 an hour
- Full-time
- Hybrid work
- Background check
- Master of Social Work
- Licensed Clinical Social Worker
- Health insurance
- Dental insurance
Quick Apply
Fire Plans Reviewer, Inspector, & Client Manager (Hybrid Role)
West Coast Code Consultants, Inc. (WC3) —San Ramon, CA
- $80,000 - $150,000 a year
- Full-time
- Hybrid work
- Background check
- Clean driving record
- Mid-level
- Profit sharing
- Paid jury duty
Quick Apply
Medical Director -- Part Time Contracted Onsite
Ventura County Health Care Plan —Oxnard, CA
- Part-time
- Medicine
- BC/BE
- 3 years
Quick Apply
UM Coordinator I
Medica Talent Group —Montebello, CA
- $24 - $25 an hour
- Full-time
- Spanish
- Word processing
- HIPAA
Quick Apply
Nurse Practitioner/Physician Assistant - Mobile Unit
East Valley Community Health Center Inc. —West Covina, CA
- $155,000 - $183,038 a year
- CPR Certification
- BLS Certification
- Primary Care
- Paid holidays
- Health insurance
Quick Apply
CCC Advanced Practice Provider (PA/NP) - (Part-time)
East Valley Community Health Center Inc. —West Covina, CA
- $77,500 - $91,519 a year
- Part-time
- CPR Certification
- BLS Certification
- Clinic
- Paid holidays
- Health insurance
Quick Apply
DashMart Team Member - Rex Manor
DoorDash Essentials, LLC —Mountain View, CA
- $20.85 an hour
- Full-time
- 18 years or older
- Customer service
- High school diploma or GED
- Commuter assistance
- Paid parental leave
Business Systems Analyst
Ledgent Technology —Newport Beach, CA
- $58 - $62 an hour
- Contract
- Research
- Mid-level
- SharePoint
- Life insurance
Quick Apply
4d
NLP Scientist
Apollo Professional Solutions, Inc. —South San Francisco, CA
- $74 an hour
- Full-time
- Mid-level
- In-person
- Health insurance
- Dental insurance
Quick Apply
1d
Sr. Tax Accountant
Robert Half —Los Angeles, CA
- $47 - $60 an hour
- Temporary
- 5 years
- Office
- US work authorization
- Disability insurance
- Dental insurance
Quick Apply
1d
Quality Assurance Reviewer
Volunteers of America Los Angeles —Los Angeles, CA
- $24.84 - $26.15 an hour
- Full-time
- Background check
- Mid-level
- US work authorization
- Health insurance
- Dental insurance
Quick Apply

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medical reviewer jobs near california

Health Care Professional – Utilization Review / First-Level Reviewer

Encompass Health Solutions, Inc. -
Los Angeles, CA

Quick Apply

Job Details

Full-time
$42 - $45 an hour
2 days ago

Qualifications

Case assessment
Phone communication
Schedule management
Typing
Productivity software

Full Job Description

About Encompass

Encompass Workers’ Comp Solutions is seeking a California-licensed healthcare professional to join our Utilization Review team as a Health Care Professional (HCP) / First-Level Reviewer.

This position may be filled by a Licensed Vocational Nurse (LVN), Registered Nurse (RN), or Doctor of Chiropractic (DC) with an active, unrestricted California license.

Founded by workers’ compensation industry veterans, Encompass is committed to delivering objective, clinically sound services while fostering a professional, supportive, and employee-centered workplace.

About the Position

The Health Care Professional performs first-level utilization review of treatment authorization requests for injured workers. The HCP reviews clinical documentation and applies California’s Medical Treatment Utilization Schedule (MTUS) and other applicable evidence-based guidelines to determine whether requested treatment meets criteria for authorization.

The HCP may approve treatment requests when applicable criteria are satisfied. Requests that cannot be approved at first-level review are prepared and referred to the appropriate Physician Reviewer.

The HCP does not modify or deny Requests for Authorization. All modification and denial decisions are made by Physician Reviewers.

What You’ll Do

Review Requests for Authorization and supporting medical documentation for completeness.
Apply MTUS and other applicable evidence-based clinical guidelines.
Determine whether sufficient clinical information is available to complete the review and request additional information when necessary.
Make first-level review determinations within applicable regulatory timeframes.
Approve treatment requests when applicable criteria are satisfied.
Communicate professionally with requesting providers to obtain additional information and discuss treatment requests as appropriate.
Prepare and refer cases that cannot be approved at first-level review to the appropriate Physician Reviewer.
Review additional medical information received in connection with reconsiderations.
Identify and appropriately process duplicate Requests for Authorization.
Maintain accurate and timely documentation of utilization review activity.
Ensure required communications and regulatory timeframes are met.

Required Qualifications

Active, unrestricted California professional license as an LVN, RN, or DC.
Must reside and work in California.
Clinical experience relevant to your licensed discipline and the clinical services being reviewed. Three or more years of relevant clinical experience is preferred.
Strong clinical assessment, critical-thinking, analytical, and problem-solving skills.
Excellent written and verbal communication skills.
Strong attention to detail, organization, and time-management skills.
Ability to work independently and manage multiple priorities and deadlines.
Ability to navigate multiple software systems concurrently.
Proficiency with Microsoft Office and web-based platforms.
Minimum typing speed of 45 WPM.
Ability to perform extensive telephone- and computer-based work.

Preferred Qualifications

Previous workers’ compensation experience.
Previous utilization review or utilization management experience.
Experience in occupational medicine, orthopedics, neurology, rehabilitation, musculoskeletal care, acute care, case management, occupational health, disability management, or another relevant clinical specialty.
Familiarity with MTUS and evidence-based treatment guidelines.
Relevant professional certification or advanced credential appropriate to your discipline.

Schedule & Work Environment

Full-time
Monday–Friday during standard business hours
Home-based/remote position
Must work from within California
Hourly, non-exempt
Overtime eligible in accordance with applicable California law

Compensation

$42.00–$45.00 per hour

The compensation range reflects the responsibilities and requirements of the Health Care Professional/First-Level Reviewer position. Actual starting compensation within the range will be based on relevant utilization review and workers’ compensation experience, clinical experience, qualifications, certifications, and other job-related factors.

Why Encompass?

This is an opportunity to use your clinical experience in a different way—helping facilitate timely, medically appropriate treatment decisions for injured workers while working in a structured, professional, home-based environment.

At Encompass, we value clinical integrity, accuracy, professionalism, and doing the right thing for our clients, providers, injured workers, and employees.

Equal Employment Opportunity

Encompass Health Solutions is an Equal Opportunity Employer. We are committed to maintaining a workplace free from discrimination and harassment in compliance with applicable federal, state, and local laws. Employment decisions are made without regard to race, color, religion, sex, gender identity, sexual orientation, age, national origin, disability, veteran status, marital status, or any other characteristic protected by law.

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Refine Your Search

medical reviewer jobs in california

Health Care Professional – Utilization Review / First-Level Reviewer

Medical Content Reviewer - Remote - Nationwide

DHR Reviewer I - Temp

Clinical Quality Reviewer - BCBA

Neuropsychologist

Neuropsychologist

Neuropsychologist

Neuropsychologist

Family Medicine Physician Focused on Pediatrics

Social Work Educator

Fire Plans Reviewer, Inspector, & Client Manager (Hybrid Role)

Medical Director -- Part Time Contracted Onsite

UM Coordinator I

Nurse Practitioner/Physician Assistant - Mobile Unit

CCC Advanced Practice Provider (PA/NP) - (Part-time)

DashMart Team Member - Rex Manor

Business Systems Analyst

NLP Scientist

Sr. Tax Accountant

Quality Assurance Reviewer

I want to receive the latest job alert for medical reviewer in california

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