Jobs in Irvine, CA

Job Title :- Medical Case Manager

BuzzClan is seeking an experienced and detail-oriented Medical Case Manager to support the BHI – BH Utilization Management department for our healthcare partner. This is a full-time, onsite opportunity for a licensed clinical professional with strong utilization management experience.

Position Details

• Department: BHI – BH Utilization Management
• Work Arrangement: Full Office (Onsite)
• Schedule: Monday through Friday, 8:00 a.m. – 5:00 p.m.

Position Summary

The Medical Case Manager is responsible for performing utilization management reviews, ensuring medical necessity determinations align with established clinical guidelines, and supporting care coordination efforts. This position plays a key role in maintaining a mission-driven culture focused on service excellence, accountability, dignity, and high-quality member care.

Duties & Responsibilities

85% – Utilization Management Services

• Participate in a high-performance, member-focused service culture.
• Collaborate with team members to support departmental goals and priorities.
• Review medical service requests using established clinical protocols to determine medical appropriateness and necessity.
• Mail decision notifications to providers and members as required.
• Screen inpatient and outpatient requests for Medical Director review.
• Gather relevant clinical documentation prior to submission.
• Communicate Medical Director determinations and document outcomes in the utilization management system.
• Complete documentation and authorization updates at the time of telephone or fax communication.
• Contact health networks and customer service departments regarding enrollments.
• Identify and report complaints through proper tracking systems or escalate urgent matters.
• Refer potential overutilization or underutilization cases to the Medical Director.
• Perform care coordination activities related to Transition Care Management (TCM).
• Review ICD-10, CPT-4, and HCPCS codes for accuracy and coverage compliance.

10% – Administrative Support

• Assist management in identifying staff training needs.
• Maintain updated departmental data resources.
• Ensure compliance with data tracking and reporting protocols.

5% – Additional Responsibilities

• Complete other duties and special projects as assigned.

Minimum Qualifications

• Current unrestricted California license (LCSW, LPCC, LMFT, or RN).
• Minimum of three (3) years of clinical experience.
• Utilization management reviewer experience required.
• Equivalent combination of education and experience may be considered.

Preferred Qualifications

• Managed care experience.
• Behavioral health clinical experience.

Required Licensure / Certifications

• Active and unrestricted California license (LCSW, LPCC, LMFT, or RN).

Knowledge, Skills & Abilities

• Ability to build strong professional relationships with internal and external stakeholders.
• Strong independent judgment and decision-making skills.
• Clear and concise verbal and written communication skills.
• Flexibility to work evenings or weekends if required.
• Strong analytical, organizational, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Experience leading or collaborating across multidisciplinary teams.
• Proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and utilization management systems.

Physical Requirements

• Ability to read information from computer screens and printed materials.
• Clear verbal communication and hearing ability.
• Manual dexterity for typing and documentation.
• Ability to sit for extended periods.
• Ability to lift 10–25 pounds when necessary.

Work Environment

Office or Remote Site

• Indoor, sedentary work environment.
• Moderate noise levels.
• Schedule variability and potential travel.
• No harmful environmental conditions.

Clinical Setting (PACE)

• Indoor clinical environment serving frail and elderly populations.
• Potential exposure to hazardous conditions.
• Moderate to loud noise levels.

Community Setting

• Indoor work with occasional outdoor responsibilities.
• Exposure to varied temperatures.
• Moderate to loud noise levels.
• Travel as required.

Location: Laguna Woods, CA | Pay: $32.60 – $34.15/hr | Shift: M-F, 8 AM – 5 PM

Our client is seeking an experienced Credentialing Specialist to manage the high-stakes privileging and enrollment processes for a busy orthopedic and multi-specialty surgical group. You will be the primary point of contact for surgeons, hospitals, and payers to ensure uninterrupted clinical operations.

Core Responsibilities

• Surgical Privileging: Coordinate OR privileges at hospitals and ASCs for orthopedic procedures (Total Knee, Arthroscopic repairs, etc.).
• Provider Enrollment: Manage Medicare/Medicaid and private payer enrollment via PECOS and CAQH to prevent claim issues.
• Primary Source Verification: Verify education and fellowships through ABOS.
• Compliance: Monitor and renew State Medical Licenses, DEA registrations, and Malpractice Insurance.

Requirements

• Experience: 2–4 years in medical credentialing (Surgical or Multi-specialty experience preferred).
• Systems: Proficiency with Modio and a background in large medical group settings is a plus.
• Education: High School Diploma required; Degree in Healthcare Admin preferred.
• Traits: High attention to detail and a self-starter mindset.

BSI Consulting Services is a trusted and agenda-shaping partner providing ‘best practice’ technical, regulatory, and business expertise and intelligence for our clients’ most critical EHS, Supply Chain, and Digital risks and opportunities to achieve greater resilience, impact, and future-readiness.

About the role

BSI is seeking a motivated and detail oriented Junior Project Coordinator to support technical projects, including large scale chemical inventory initiatives and other client programs. This role is ideal for an organized professional who thrives in a fast paced, client focused environment and enjoys supporting complex, multi stakeholder projects.

In this role, you will coordinate day to day project activities across complex environments such as multi building and multi laboratory campuses. You will work closely with project managers, technical staff, and client stakeholders to ensure projects remain on schedule, data is accurately maintained, and communications are handled professionally.

Key responsibilities:

• Coordinate and manage scheduling for teams supporting technical projects across numerous buildings, laboratories, and stakeholders
• Communicate directly with lab owners, researchers, and internal staff to confirm access, availability, and daily work plans
• Maintain project schedules, trackers, and calendars to support multi month project execution
• Identify scheduling conflicts or constraints and partner with the project team to resolve issues efficiently
• Enter, update, and maintain project and inventory data while performing data quality checks
• Provide client facing administrative and coordination support, including project communications and documentation

What we’re looking for:

• Experience in an administrative, coordination, data entry, or project support role
• Strong written and verbal communication skills with the ability to interact professionally with diverse stakeholders
• High attention to detail and strong organizational skills
• Demonstrated ability to problem solve and adapt in a fast paced, deadline driven environment
• Proficiency with Outlook, Excel, project trackers, and databases. Experience with Apple Mac operating systems is a plus
• Exposure to technical, scientific, laboratory, or regulated environments or multi site projects preferred

What we offer:

BSI offers a competitive salary, group-sponsored health and dental, short-term and long-term disability, a company-matched 401k plan, company paid life insurance, 11 paid holidays and 4 weeks paid time off.

The salary for this position can range from $70,000 to $80,000 annually; actual compensation is based on various factors, including but not limited to, the candidate’s competencies, level of experience, education, location, divisional budget and internal peer compensation comparisons.

Do you believe the world deserves excellence?

We are proud to be the business improvement company for other organizations to become more sustainable and resilient and finally to inspire trust in their products, systems, services, and the world we live in.

Headquartered in London, BSI is the world's first national standards organization with more than 100 years of experience. We are a global partner for 86,000 companies and organizations in over 193 countries, offering development, auditing, certification, and training services, including innovative software solutions and cyber security expertise for all industries: from aerospace and automotive to food, construction, energy, healthcare, IT and trade sectors. Incorporated by Royal Charter, we’re truly impartial, and home to the ultimate mark of trust, the Kitemark.

Through our unique combination of consulting, training, assurance and regulatory services we bring solid and broad knowledge to every company.

If you want to contribute to this inspiring challenge, bring your open and enthusiastic mindset to our dynamic team, apply now and become part of the BSI family!

D&I Policy

BSI is committed to ensuring the diversity of our workforce reflects that of our clients and the communities in which we operate. Our goal is to create a sense of belonging for all employees by providing opportunities to develop, grow, and engage with our global organization all while having fun doing great work. BSI is a community where everyone can thrive.

If you require any reasonable accommodations to be made on account of a disability or impairment throughout out our recruiting process, please inform your Talent Acquisition Partner.

DocCafe has an immediate opening for the following position: Physician - Family Practice-Without OB in Tustin, California.

Make $151 - $162/hourly.

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Workers Compensation Litigation Associate

Location

Costa Mesa

Remote Work Flexibility

Experience the freedom of working remotely for a portion of your workweek. Our infrastructure enables seamless communication, collaboration, and access to resources from anywhere.

About the Company

Manning Kass is a national civil litigation defense firm that stands out from the rest—every case and client matters. Established in 1994 with just sixteen attorneys, we have expanded over the past thirty years to more than 160 attorneys across seven offices, including major economic hubs like New York and Los Angeles.

About the Role

Manning Kass is currently seeking a Workers Compensation Litigation Associate to join our team! The position will help manage a diverse range of cases, including defending employers and insurers against employment related litigation. Associates work closely with lead attorneys daily, engaging in all phases of litigation—from case evaluation and discovery to attending workers' compensation appeal board hearing.

Associates benefit from collaborative, team-based support while gaining hands-on experience. The ideal candidate must be eager to learn, self-motivated, and interested in long-term professional growth.

Responsibilities

• The candidate must have strong analytical skills.
• Active membership in the California State Bar and in good standing.
• A self-starter with the ability to work independently and as part of a team.
• Strong legal research and writing skills, with attention to detail.
• Proactively manage communications with clients throughout the course of litigation.

Professional Development Opportunities

We are committed to investing in our team's professional growth. Our distinctive "Manning Kass University" training program offers tailored education and development opportunities to help you thrive as a successful lawyer. Opportunity to mediate, arbitrate, and try cases while learning from the firm's experienced ABOTA trial attorneys.

Requirements

• Juris Doctor (J.D.) degree.
• You must be licensed to practice in the State of California.
• 1+ year of workers' compensation experience is preferred but not required.
• Strong legal research and writing skills, with attention to detail.
• Exceptional communication, advocacy, and analytical skills.
• Excellent time management skills and ability to manage and meet deadlines.

Company Offers

• Salary Range $125,000-$175,000 + bonus. The actual compensation offered to a candidate will be dependent on a variety of factors including, but not limited to, the candidate's experience, and qualifications.
• Comprehensive benefits package, including medical, dental, vision, disability, life, flexible spending account, and 401K.
• Pet insurance coverage.
• Referral program.
• A company culture that fosters career growth and opportunity.
• All applications will be treated with the utmost confidentiality.

About Origence

With 30 years at the forefront of fintech innovation, we specialize in SaaS lending solutions that lead the industry. Our core mission is customer-centric, focusing on empowering Credit Unions across the United States with the tools to offer accessible, competitive lending services. We're deeply committed to enhancing the financial ecosystem for a broad network of credit unions, members and auto dealers. We invest in our greatest assets, our employees, and foster a culture of innovation and ownership through freedom and responsibility. We celebrate fiscal accountability, operational rigor and efficiency to create a sustainably healthy and robust business for the long term.

The Associate Corporate Attorney has experience in indirect lending, direct lending, financial services, privacy, and FinTech matters in the Credit Union Service Organization and licensed lender space. The Associated Corporate Attorney provides direct support for senior attorneys, is an active partner to internal business clients in addition to providing timely and accurate advice, drafts and negotiates complex and novel contracts with minimal supervision, ensures compliance with regulatory standards, and actively contributes to legal risk mitigation strategies.

What You'll Be Doing:

• Draft, review, and negotiate a wide variety of commercial contracts, including but not limited to licensing agreements, service agreements, NDAs, data protection agreements, lender agreements, partner and lead generator letters of understanding, and other legal documents independently or at the direction of the senior attorneys.
• Provide legal advice on regulatory, compliance, privacy, and business issues affecting financial services, licensed lender, and SaaS operations.
• Conduct legal research and analysis of statutes, regulations, and case law relevant to company operations.
• Support litigation matters, including strategy, calendaring, discovery, briefings, and outside counsel involvement as needed.
• Update internal policies, procedures, and manuals.
• Monitor and interpret changes in regulatory frameworks and industry best practices affecting the credit union and licensed lender industry.
• Maintain organized legal files, and report on and track key deadlines.

The Ideal Candidate:

Education:

• Juris Doctor (J.D.) from an accredited law school and admission to the California Bar (Registration under Rule 9.46. Registered In-House Counsel accepted but must be indicated on application).

Experience:

• Juris Doctor (J.D.) from an accredited law school and admission to the California Bar (Registration under Rule 9.46. Registered In-House Counsel accepted but must be indicated on application. If admitted under Rule 9.46, please provide proof of successful bar passage, applicable state diploma privilege will not be accepted as proof of successful bar passage.).
• Minimum 2-3 years of relevant legal experience in a law firm, in-house legal department, or similar setting. 3+ years of prior experience as a non-attorney in financial services will count toward the minimum years of experience.
• Experience with financial services, licensed lender, or FinTech legal issues OR SaaS/technology company legal matters.

Specialized Skills:

• Strong drafting, negotiation, and analytical skills.
• Excellent communication and stakeholder management capabilities.
• Ability to prioritize and manage multiple assignments under tight deadlines.
• Experience advising on regulatory compliance (e.g., consumer financial protection statutes, data privacy, software licensing).
• Exposure to commercial technology contracts or subscription services.
• Prior exposure to litigation support or regulatory investigations.

Why you should apply:

• Flexible Working Environment
• Paid Time Off
• 401k (8% match)
• College Tuition Benefits/ Tuition Reimbursement
• Good Benefits options
• Company Culture! Cultural and Holiday celebrations, Theme days like Star Wars Day & Bring your Kids to Work Day, Monthly Townhalls and Quarterly Company Meetings that ensure awareness, inclusion, and transparency.

The starting salary range for this full-time position in Irvine, CA is $111800 - $139800 per year. This base pay will take into consideration internal equity, candidate's geographic region, job-related knowledge and experience among other factors. Origence maintains a highly competitive compensation program. Under company guidelines, this position is eligible for an annual bonus to provide an incentive to achieve targeted goals. Bonuses are awarded at company's discretion on an individual basis.

Origence is an equal opportunity employer. All recruitment, hiring, training, compensation, benefits, discipline, and other terms and conditions of employment will be based upon an individuals' qualifications regardless of race, religion, color, sex, gender identity, sexual orientation, national origin, ancestry, military service, marital status, pregnancy, age, protected medical condition, genetic information, disability or any other category protected by federal, state or local law.

We're looking for Neonatal Intensive Care Unit RNs for an immediate travel nurse opening in Mission Viejo, CA. The right RN should have 1-2 years' recent acute care experience. Read below for more requirements.

As a NICU RN, you'll provide critical care to sick and premature infants. Alongside the rest of the care team, NICU RNs assist in providing round-the-clock care to these patients and support to the parents. Parental support can range from emotional encouragement to advising parents on the proper care of their infant when they return home.

As a NICU Travel Nurse, you should be prepared to perform the following tasks:

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• Care for infants transitioning to extra uterine life.
  
• Monitor vital signs and initiate corrective action when necessary.
  
• Provide nutritional assessment and specialized feedings.
  
• Change dressings, insert catheters, start IVs.
  
• Provide arterial and intravenous therapy.
  
• Monitor and adjust specialized equipment used on patients, such as incubators and ventilators.