Top 375 Prior authorization Jobs in Los Angeles, Ca

Delegation Oversight
Champion Health Plan —Long Beach, CA
- From $60,000 a year
- Full-time
- Microsoft Excel
- LVN
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Referral Clinical Coordinator
OneLegacy —El Segundo, CA
- $64,464.40 - $77,077.00 a year
- 12 hour shift
- LVN
- Hospital
- Mid-level
- Mileage reimbursement
- Health insurance
Quick Apply
Referral Clinical Coordinator
OneLegacy —Mission Hills, CA
- $64,464.40 - $77,077.00 a year
- 12 hour shift
- LVN
- Hospital
- Mid-level
- Mileage reimbursement
- Health insurance
Quick Apply
Prior Authorization & Referral Coordinator
OPN Healthcare —Glendale, CA
- $18 - $22 an hour
- Full-time
- Microsoft Word
- Background check
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
Financial Care Specialist
HRC Fertility Management —Encino, CA
- $23 - $25 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Writing skills
Quick Apply
11d
Pre-Registration Representative
UCLA Health —Los Angeles, CA
- $30.36 - $43.49 an hour
- Mid-level
- Typing
- Medical terminology
12d
Administrative Assistant I
The Metropolitan Water District of Southern California —Los Angeles, CA
- $34.38 - $45.26 an hour
- Full-time
- Hybrid work
- Office
- Administrative experience
- High school diploma or GED
- Dental insurance
- Tuition reimbursement
Insurance Authorization Specialist Full-Time Varied
Hollywood Presbyterian —Los Angeles, CA
- $30.12 - $34.98 an hour
- 8 hour shift
- Writing skills
- Mid-level
- High school diploma or GED
Quick Apply
23h
Patient Access Liaison - Rare Disease - US Field (West)
Amgen —Los Angeles, CA
- $158,394 - $222,256 a year
- Weekends as needed
- Doctoral degree
- Up to 50% travel
- HIPAA
- Disability insurance
- Health insurance
Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
USC —Los Angeles, CA
- $25.00 - $39.69 an hour
- 8 hour shift
- Nursing
- LVN
- Hospital
Referral Clinical Coordinator
OneLegacy —Azusa, CA
- $58,604 - $70,707 a year
- 12 hour shift
- LVN
- Hospital
- Mid-level
- Mileage reimbursement
- Health insurance
Quick Apply
Accounts Recievable Biller
Career Group Companies —Montebello, CA
- $35 - $45 an hour
- Full-time
- Hybrid work
- Mid-level
- Fair chance
- Communication skills
- Flexible schedule
Quick Apply
12d
Ambulatory Pharmacy Technician - Prescription Management
UCLA Health —Los Angeles, CA
- $30.32 - $40.04 an hour
- Weekends as needed
- Mid-level
- Outpatient experience
- Ability to lift 50 pounds
Ambulatory Pharmacy Technician
UCLA Health —Los Angeles, CA
- $27.88 - $40.04 an hour
- Weekends as needed
- Ability to lift 50 pounds
- Ability to sit for extended periods
- Medical terminology
Ambulatory/Outpatient Pharmacy Technician
UCLA Health —Los Angeles, CA
- $27.88 - $40.04 an hour
- Weekends as needed
- Outpatient experience
- Ability to lift 50 pounds
- Ability to sit for extended periods
10d
LVN - Utilization Management
Cross Country Local —Montebello, CA
- $35 - $46 an hour
- 8 hour shift
- LVN
- BLS Certification
- Mid-level
- Health insurance
- 401(k) matching
Quick Apply
5d
Utilization Review Coordinator
Prosperous Health —Los Angeles, CA
- $70,000 - $80,000 a year
- Full-time
- Hybrid work
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
5d
Patient Access Representative - Per Diem
UCLA Health —Santa Monica, CA
- $38.96 an hour
- Weekends as needed
- Spanish
- Microsoft Outlook
- Basic math
Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Keck Medical Center of USC —Los Angeles, CA
- $25.00 - $39.69 an hour
- 8 hour shift
- Background check
- Nursing
- LVN
Sr. Patient Access Representative
Adventist Health —Los Angeles, CA
- $25.00 - $30.91 an hour
- Full-time
- Hospital
- Mid-level
- High school diploma or GED

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Delegation Oversight

Champion Health Plan
Long Beach, CA

Quick Apply

Job Details

Full-time
From $60,000 a year

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance

Qualifications

Teamwork
Microsoft Excel
CMS
Master's degree
CMS regulatory compliance
Documentation tools
Bachelor's degree
Health insurance knowledge
Organizational skills
Productivity software

Full Job Description

Delegation Oversight Specialist

Position Summary:
The Delegation Oversight Specialist is responsible for overseeing all components of health plan delegation oversight, including audits, internal reviews, and performance monitoring to ensure compliance with regulatory and contractual requirements. This position plays a critical role in supporting audit readiness, quality initiatives, and interdepartmental collaboration across delegated functions.

Primary Responsibilities:

Prepare and submit pre-audit documentation in alignment with health plan tools and timelines
Coordinate, conduct, and document pre-delegation and annual oversight audits to comply with NCQA, CMS, DMHC, DHCS, and other applicable standards
Facilitate onsite, virtual, and desktop audits to evaluate adherence to plan-specific and regulatory requirements
Serve as the main point of contact for health plan auditors and regulatory bodies during all audit phases
Distribute audit result letters, follow-up communications, audit tools, and annual reporting requirements
Conduct internal audits of the end-to-end departments process and perform focused audits based on trends, CAPs, or new workflows
Collaborate with internal teams to collect and review required documentation and ensure timely responses to audit requests
Assist in the preparation of audit summaries, internal dashboards, and reports for Committees and Joint Operations Committees (JOCs)
Monitor performance of delegated entities and support continuous quality improvement initiatives

Minimum Qualifications:

Bachelor’s degree in Healthcare Administration, Public Administration, Health Policy, or a related field (Master’s degree preferred)

OR equivalent combination of education and relevant managed care experience

Experience working in a managed care organization, HMO, MSO, or health plan setting
Working knowledge of NCQA standards, CMS, DMHC, and DHCS regulatory requirements
Familiarity with prior authorization and utilization management processes
Advanced proficiency in Microsoft Office Suite (Excel, Word, PowerPoint)
Experience with Quick CAP, EZ-CAP, or similar health plan systems is a plus

Preferred Qualifications:

3+ years of experience in healthcare operations, managed care, utilization management, or quality oversight
Experience supporting delegated entities such as provider groups, IPAs, or MSOs
Prior involvement with audit preparation, corrective action plans (CAPs), and regulatory reporting
Exposure to NCQA accreditation readiness or survey support
Excellent organizational, analytical, and written/verbal communication skills
LVN/LPN licensure is a plus but not required

Job Type: Full-time

Pay: From $60,000.00 per year

Benefits:

401(k)
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Ability to Commute:

Long Beach, CA 90815 (Required)

Ability to Relocate:

Long Beach, CA 90815: Relocate before starting work (Required)

Work Location: In person

Quick Apply

Refine Your Search

prior authorization jobs in los angeles, ca

Delegation Oversight

Referral Clinical Coordinator

Referral Clinical Coordinator

Prior Authorization & Referral Coordinator

Financial Care Specialist

Pre-Registration Representative

Administrative Assistant I

Insurance Authorization Specialist Full-Time Varied

Patient Access Liaison - Rare Disease - US Field (West)

Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Referral Clinical Coordinator

Accounts Recievable Biller

Ambulatory Pharmacy Technician - Prescription Management

Ambulatory Pharmacy Technician

Ambulatory/Outpatient Pharmacy Technician

LVN - Utilization Management

Utilization Review Coordinator

Patient Access Representative - Per Diem

Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Sr. Patient Access Representative

I want to receive the latest job alert for prior authorization in los angeles, ca

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