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assistant clinical research coordinator

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clinical research regulatory specialist

University of Southern California

<div><b>Job ID</b> REQ20177368 <b>Category</b> Keck Medicine of USC</div>
<br><div><div><div><p>As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various entities of Keck Medical Center of USC and monitors the alignment of the various entities to the standard policy for maintaining the CDM. The RI Specialist is responsible for the timely and accurate synchronization of data between the CDM residing in the billing system and CDM management tools . The Senior RI Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided. This includes ensuring all annual updates required by Medicare and other third-party payers are up to date. The Senior RI Specialist delivers direction to the documentation of all policies and procedures regarding CDM Maintenance and charge process; and conducts meetings to evaluate department charge processes to improve charge capture and coding compliance. The Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement. The Senior RI Specialist works closely with revenue auditors and provides leadership by providing direction to the revenue auditor team to all entities of Keck Medical Center of USC in the research and resolution of requests in a timely manner; and aid in the training and skill development of auditors to maximize available tools for Chargemaster and billing compliance.<br>
<br>
<b>Essential Duties:</b></p></div><div><ul><li><p>
Performs maintenance to the Keck Medical Center of USC Charge Description Master (Keck &amp; Norris) ensuring all annual updates required by Medicare and other third-party payers are up to date. Assists the Revenue Cycle in annual coding review and processing of updates.</p></li></ul></div><div><ul><li><p>
Reviews and process requests for new code additions, code set corrections, revenue code to CPT/HCPCS code mismatch corrections and on-going identified changes for current systems to maintain compliance with both state and federal regulatory agencies.</p></li></ul></div><div><ul><li><p>
Leads and conducts meetings with Operations Leaders, Revenue Auditors, Clinical Department Staff, and Gatekeepers to address issues involving compliance with government regulations, third party payor needs and industry standards.</p></li></ul></div><div><ul><li><p>
Acts a subject matter expert for projects that impact revenue integrity and CDM. Subject matter expert to meet and/or communicate with various stakeholders for projects that impacts revenue integrity and the CDM.</p></li></ul></div><div><ul><li><p>
Takes the lead and exercises significant judgement and discretion on projects that have a broad, organizational impact.</p></li></ul></div><div><ul><li><p>
Coordinates and provides leadership to Revenue/Chart Audit team associated with research and resolution of account issues related to the CDM, charge capture, and other issues considered to be revenue integrity.</p></li></ul></div><div><ul><li><p>
Synchronizes CDM data between CDM and CDM Workflow &amp; Management Tool for Keck Medical Center of USC entities on a monthly basis.</p></li></ul></div><div><ul><li><p>
Imports/extracts data from various sources and in various formats as needed to review, monitor, track, and maintain the integrity of the CDM and associate charge flow process.</p></li></ul></div><div><ul><li><p>
Provides CDM data as necessary based on identified issues in form of ad-hoc reports.</p></li></ul></div><div><ul><li><p>
Provides guidance and education to ensure that CDM&rsquo;s and Charge Capture as needed of exist and newly acquired entities (i.e. Verdugo Hills) follow the standards and policies of Keck Medical Center of USC.</p></li></ul></div><div><ul><li><p>
Performs charge reconciliation activities, industry best practice research, and identifies and deploys charge capture improvement initiatives.</p></li></ul></div><div><ul><li><p>
Interprets and explains on details of charge services provided as needed.</p></li></ul></div><div><ul><li><p>
Participates collaboratively with Revenue Cycle and Ancillary team in the development, execution, and follow-up of education programs for USC Administration, Managers and Staff on all issues related to the charge master, charge capture, and new applications related processes.</p></li></ul></div><div><ul><li><p>
Participates in the development of policies and procedures, monitoring tools for late charges and establishment of procedures for timely and accurate charge capture mechanisms.</p></li></ul></div><div><ul><li><p>
Enhances professional growth and development</p></li></ul></div><div><ul><li><p>
Actively participates in team development, contributes to dashboards, and in accomplishing team, departmental, and organizational goals and objectives.</p></li></ul></div><div><ul><li><p>
Performs other duties as assigned.</p></li></ul></div><p></p><div><p><b>
Required </b><b>Qualifications:</b></p></div><div><ul><li><p>
Req Associate&rsquo;s Degree Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or similar/related field.</p></li></ul></div><div><ul><li><p>
Req Specialized/technical training Certification from an accredited program of Certified Coder (CPC/CCS/COC) or Certificate of Auditing (CPMA) within one year from date of hire.</p></li></ul></div><div><ul><li><p>
Req 5 years Experience in healthcare field required. Related experience may include a combination of clinical service delivery (nursing or allied health), coding, provider billing, medical records, charge audit environment, CDM maintenance, Medicare/Medicaid reimbursement, managed care contractual arrangements, and patient accounting.</p></li></ul></div><div><ul><li><p>
Req Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodology.</p></li></ul></div><div><ul><li><p>
Req Knowledge of other government and third-party payer reimbursement methodologyrequired.</p></li></ul></div><div><ul><li><p>
Req Must be able to implement a systematic, self-motivated approach to problem solving and be able to identify, coordinate and optimize resources needed to execute plan</p></li></ul></div><div><ul><li><p>
Req Proficient skills and knowledge in MS Office/ Windows</p></li></ul></div></div><p></p><div><div><p><b>
Preferred Qualifications:</b></p></div><div><ul><li><p>
Pref Bachelor&rsquo;s Degree Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or similar/related field.</p></li></ul></div><div><ul><li><p>
Pref Previous hospital Chargemaster experience, including the use of CDM Maintenance software (Craneware or Med Assets).</p></li></ul></div><div><ul><li><p>
Pref Experience and knowledge of Hospital charging practices.</p></li></ul></div><div><ul><li><p>
Pref Healthcare operations experience, particularly in an acute care hospital setting.</p></li></ul></div><div><ul><li><p>
Pref Current knowledge of the Revenue cycle, specifically the flow of charges in and across hospital billing systems.</p></li></ul></div><div><ul><li><p>
Pref Working knowledge of CPT, HCPCs and ICD9 coding principles.</p></li></ul></div><div><ul><li><p>
Pref Skills and knowledge on the following software: Cerner and Craneware</p></li></ul></div><p></p><div><p><b>
Required </b><b>Licenses/</b><b>Certifications:</b></p></div><div><ul><li><p>
Req Specialty Certification Certified Coder (CCS or CPC), Certified Outpatient Coder-COC (AAPC) or Certified Auditor (CPMA) obtained within one (1) year of date of hire.</p></li></ul></div><div><ul><li><p>
Pref Registered Nurse - RN (CA Board of Registered Nursing)</p></li></ul></div><div><ul><li><p>
Pref Pharmacy Technician (CA DCA)</p></li></ul></div><div><ul><li><p>
Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)</p></li></ul></div></div><br>
<p></p>
Keck Hospital of USC, a 343-bed acute care hospital, provides exceptional and innovative care for complex medical and surgical conditions across a wide range of specialties. The hospital&rsquo;s world-renowned physicians deliver compassionate, customized, patient-centered care and treat the most acutely ill patients with highly innovative techniques and treatment plans. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere. Every day at Keck Hospital, physicians, nurses and staff go beyond the science of exceptional medicine to bring patients breakthroughs in the art of caring. Join this world-class team providing highly specialized care, up-to-the-minute research, and innovative clinical trials. The annual base salary range for this position is $99,507.00 - $164,559.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate&rsquo;s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
<div><b>Job ID</b> REQ20177368 <b>Posted Date</b> 07/10/2026</div></div><p></p>

Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Exempt) (Non-Union)

Innovative Clinical Research Institute, LLC

<p><b>Job Overview</b></p><p>We are seeking a highly motivated and detail-oriented Assistant Clinical Research Manager to join our dynamic research team. In this vital role, you will support the planning, execution, and oversight of clinical trials, ensuring adherence to regulatory standards and ethical guidelines. Your energetic approach will help drive research projects forward, facilitate compliance, and maintain high-quality data collection. This position offers an exciting opportunity to contribute to groundbreaking healthcare advancements while developing your expertise in clinical research management.</p><p><b>Responsibilities</b></p><ul><li>Assist in coordinating all phases of clinical trials, from protocol development to study completion, ensuring timely progress and compliance with regulatory standards.</li><li>Supervise research staff and study coordinators, providing guidance on clinical procedures, documentation review, and data collection methods, and at the same time, step in as study coordinator when needed.</li><li>Monitor patient safety and well-being throughout the trial process, including blood sampling, patient monitoring, and adverse event reporting.</li><li>Review study documentation for accuracy and completeness, ensuring adherence to FDA regulations, ICH GCP guidelines, and clinical ethical standards.</li><li>Manage data entry and analysis using statistical software and ensure data management practices align with CDISC standards.</li><li>Oversee compliance with healthcare regulations and clinical quality assurance standards across all research activities.</li><li>Collaborate with cross-functional teams to ensure proper use of EMR systems and adherence to project timelines in a fast-paced research setting.</li></ul><p><b>Experience</b></p><ul><li>Proven supervising experience in a clinical research environment or healthcare setting.</li><li>Strong knowledge of medical terminology, clinical laboratory procedures, and blood sampling techniques.</li><li>Experience reviewing documentation for accuracy and compliance within clinical trials or research projects.</li><li>Familiarity with statistical software tools used for data analysis in clinical studies.</li><li>Understanding of FDA regulations, ICH GCP guidelines, and healthcare compliance standards related to clinical research.</li><li>Hands-on experience with EMR systems, project management tools, and data management platforms such as CDISC standards.</li><li>Certification in ICH GCP (Good Clinical Practice) from a recognized issuer is required; valid CA certification is preferred for applicable regions.</li><li>Demonstrated ability to manage multiple projects simultaneously while maintaining attention to detail and quality assurance standards.</li><li>Minimum 2 to 5 years clinical research experience</li><li>Foreign Medical Graduate or Bachelor's Degree</li></ul><p>Join us in advancing healthcare through innovative research! We are committed to fostering a collaborative environment where your skills can thrive while making a meaningful impact on patient care worldwide. All roles are paid positions that support your professional growth within a vibrant research community dedicated to excellence.</p><p>Pay: $29.00 - $33.00 per hour</p><p>Benefits:</p><ul><li>401(k)</li><li>Dental insurance</li><li>Employee assistance program</li><li>Employee discount</li><li>Flexible spending account</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Work Location: In person</p>

Assistant Clinical Research Manager

Kaiser Permanente

<div><div><b>Job Summary:</b></div>
<br>
Collects data for clinical trials research, independently. Prepares and/or supports the submission of study documentation to regulatory bodies (e.g., IRB) for pre-implementation review and approval. May support clinical trials activities and research lab operations. Completes timely and accurate documentation of all research activities (e.g., consent forms, reports). Assists with the development and/or implementation of standard and non-standard quality control and/or assurance measures and documents feedback to research staff and management. Supports and develops materials for the education of research staff and/or participants on protocols, documentation procedures, clinical best practices, or timeliness of submissions, with limited guidance. Learns about providing input on implementing budgeting components for internally funded standard and non-standard projects. Drafts and/or prepares and submits clinical trials applications in compliance and consistency with all applicable federal, state, and local regulations and KP policies and procedures.<div><br>
<b>
Essential Responsibilities:</b></div><br>
<br>
<ul><li>Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.</li><br>
<li>
Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team.</li><br>
<li>
Works on budgeting and financing by: developing a working understanding of how to provide input on implementing budget components for internally funded standard and nonstandard projects.</li><br>
<li>
Conducts clinical research by: independently collecting data in clinical trials (e.g., recruiting human subjects, administering surveys and/experiments); leveraging a comprehensive foundational knowledge of source data and the tools leveraged for analyzing, and interpreting clinical data; leveraging a comprehensive foundational knowledge of clinical trials, studies, and interventions at the site-level; independently contributing to the development of standard and nonstandard clinical research protocols and other processes of clinical trials; preparing and/or supporting the submission of study documentation to regulatory bodies (e.g., IRB) for review and approval prior to implementation; may also be responsible for executing standard and non-standard clinical trial activities (e.g., informed consent process, lab support and processing, pharmaceutical documentation data, sample processing, adverse event assessment process); and may be involved in supporting standard and non-standard research lab operations(e.g., biological specimen collection, including patient preparation, labeling, handling, preservation or fixation, processing or preparation, and transportation and storage of specimens).</li><br>
<li>
Ensures research compliance by: independently drafting and/or preparing and submitting clinical trial applications in compliance and consistency with all applicable federal, state, and local regulations, and reviewing and providing input on KP compliance policies and procedures; identifying compliance and/or quality issues and assisting in the development of corrective action plans, escalating as necessary; identifying opportunities to update compliance-monitoring/audit systems and documentation; utilizing standard approaches to analyze risk-management data and making recommendations to mitigate potential risk; independently implementing research protocols, procedures, and guidance to ensure confidentiality, privacy, and security of clinical research data; and leveraging comprehensive research expertise to provide guidance to investigators and other key stakeholders to ensure compliance with IRB approved protocols and local and federal guidelines.</li><br>
<li>
Maintains internal and external effective working relationships by: leveraging a comprehensive foundational knowledge of how to partner with research stakeholders and investigators within and across units to contribute to research projects; independently communicating with key contractors and subcontractors, study sponsors, collaborating internal and/or external clinical sites, and data coordinating centers as applicable; and developing materials for supporting the education of staff and/or participants on protocols, documentation procedures, clinical best practices, or timeliness of submissions with limited guidance.</li><br>
<li>
Ensures documentation of clinical research files by: completing documentation of all research activities (e.g., consent forms, reports, tracking forms) in a timely and accurate manner; assisting with the development and/or implementation of standard and nonstandard quality control and/or assurance measures and documenting feedback for the research staff and management; assessing volunteers and/or patients for eligibility to participate in Clinical Trials using standard procedures and criteria; and leveraging a comprehensive foundational knowledge of how to monitor and audit Clinical Trials as well as documenting findings.</li></ul><div><b><br>
Knowledge, Skills and Abilities: (Core)</b></div><ul><li>
Ambiguity/Uncertainty Management</li><li>
Attention to Detail</li><li>
Business Knowledge</li><li>
Communication</li><li>
Critical Thinking</li><li>
Cross-Group Collaboration</li><li>
Decision Making</li><li>
Dependability</li><li>
Diversity, Equity, and Inclusion Support</li><li>
Drives Results</li><li>
Facilitation Skills</li><li>
Health Care Industry</li><li>
Influencing Others</li><li>
Integrity</li><li>
Learning Agility</li><li>
Organizational Savvy</li><li>
Problem Solving</li><li>
Short- and Long-term Learning &amp; Recall</li><li>
Teamwork</li><li>
Topic-Specific Communication</li></ul><div><b><br>
Knowledge, Skills and Abilities: (Functional)</b></div><ul><li>
Accountability</li><li>
Adaptability</li><li>
Autonomy</li><li>
Business Relationship Management</li><li>
Clinical Research</li><li>
Clinical Research Quality</li><li>
Compliance</li><li>
Computer Literacy</li><li>
Data Quality</li><li>
Experimental Design</li><li>
Innovative Mindset</li><li>
Laboratory Equipment</li><li>
Laboratory Procedures</li><li>
Managing Diverse Relationships</li><li>
Organizational Skills</li><li>
Project Management</li><li>
Project Management Tools</li><li>
Quality Assurance Process</li><li>
Quantitative Research Methods</li><li>
Research Ethics</li><li>
Stakeholder Management</li><li>
Survey Methodology</li><li>
The Scientific Method</li></ul><div><br>
<b>Minimum Qualifications:</b></div><br>
<br>
<ul><li>Bachelors degree in Science, Public Health, Health Care Administration, or related field AND minimum two (2) years of experience in clinical research or a directly related field OR Minimum five (5) years of experience in clinical research or a directly related field.</li></ul><div><b><br>
Preferred Qualifications:</b></div><ul><li>
Certified Clinical Research Professional (CCRP) from Society of Clinical Research Associates (SoCRA); OR ACRP Certified Professional, Certified Clinical Research Associate, Certified Clinical Research Coordinator, Certified Principal Investigator, ACRP Medical Device Professional, or ACRP Project Manager from Association of Clinical Research Professionals (ACRP); OR Certified in Healthcare Compliance (CHC) from Healthcare Compliance Association (HCCA).</li><li>
Basic Life Support (BLS) Certification.</li></ul><br>
PrimaryLocation : California,Los Angeles,4733 Sunset Annex<br>
HoursPerWeek : 40<br>
Shift : Day<br>
Workdays : Mon, Tue, Wed, Thu, Fri<br>
WorkingHoursStart : 08:00 AM<br>
WorkingHoursEnd : 05:00 PM<br>
Job Schedule : Full-time<br>
Job Type : Standard<br>
Employee Status : Regular<br>
Employee Group/Union Affiliation : NUE-SCAL-01|NUE|Non Union Employee<br>
Job Level : Individual Contributor<br>
Job Category : Research<br>
Department : Department of Research and Evaluation<br>
Travel : Yes, 50 % of the Time<br>
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.<br>
<br>
For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:<br>
<br>
<ul><li>Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.</li></ul><br>
<ul><li>Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty, shows consistency in words and actions; follows through on commitments.</li></ul><br>
<ul><li>Job duties with at least occasional or possible access to: (1) patients, the general public, or other employees; (2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (4) controlled substances regulated by federal law or potentially subject to diversion.</li></ul></div>

Clinical Research Coordinator III, Cardiac Clinical Trials

Cedars-Sinai Medical Center

<div><div><div><div><b>Job ID</b> 19244 <b>Location </b>Los Angeles, California, United States <b>Job Category</b> Academic / Research <b>Date posted</b> 07/24/2026
</div></div><p></p><div>
</div></div><div><h2 class="jobSectionHeader"><b>Job Description</b></h2>
<p><b>Are you ready to be a part of breakthrough research?</b></p>
<p>The Clinical Research Coordinator III (CRC Lead) is responsible for project allocation and immediate oversight of clinical research coordinators and clinical research associates, along with primary coordination of assigned studies. This includes managing schedules and coverage for the coordinator team, improving efficiency of research systems and processes, training of personnel, and resolution of day-to-day administrative and operational problems to ensure the successful implementation of research protocols.</p>
<p><b>Primary Duties and Responsibilities:</b></p>
<ul><li>Responsible for immediate oversight of CRC team, including project allocation, staff scheduling and staff training; contributes to performance reviews for CRC team.</li>
<li>Identifies and ensures needed resources and logistics for research activities, including determining appropriate course of action in solving day-to-day research operations problems.</li>
<li>Responsible for departmental reporting related to protocol activity, accrual data, workload, and other research information; present this information to management.</li>
<li>Participates in project feasibility reviews and study initiation visits and provides strategic guidance on study set-up and implementation.</li>
<li>Identifies quality and performance improvement opportunities and collaborates with staff in the development of action plans to improve quality and efficiency.</li>
<li>Provides oversight for institutional, pharmaceutical and internal audits, including facilitating third party study monitoring and designs and implements needed corrective actions.</li>
<li>Provides assistance with research project budget development, including identifying and classifying routine care vs. research related care and provides assistance with research participant research billing and reconciliation.</li>
<li>Provides study coordination for assigned projects, including patient screening and consenting, regulatory reporting, completion required data collection, maintenance of source documents, facilitation of all study logistics to ensure successful protocol implantation and patient safety.</li>
<li>Attend meetings and conferences related to research activities, including research staff meetings.</li>
<li>Participate in planning, workshops, evaluation meetings, and seminars, educational or administrative meetings as necessary or requested.</li>
</ul><h2 class="jobSectionHeader"><b>Qualifications</b></h2>
<p><b>Education:</b></p>
<ul><li>Bachelor's degree in a related field is required. Master's degree is preferred.</li>
</ul><p></p><p><b>Licenses and Certifications:</b></p>
<ul><li>SoCRA or ACRP certification within one (1) year of hire.</li>
<li>Basic Life Support (BLS) from the American Heart Association is required.</li>
<li>Phlebotomy Certification (CPT) from CDPH is preferred.</li>
<li>Certified Registered Medical Assistant is preferred.</li>
</ul><p></p><p><b>Experience and Skills:</b></p>
<ul><li>Five (5) years of clinical research coordination or related experience is required.</li>
<li>Maintains comprehensive knowledge of all departmental research protocols to ensure the compliant execution of studies in accordance with research governing entity requirements, including but not limited to Sponsor, FDA and IRB requirements.</li>
<li>Ability to use software applications and operate technological devices (e.g., computer, laptop, tablet, smartphone, etc.</li>
<li>Acts as a team lead to include overseeing the work of others, assigning or allocating work to team, and ensuring tasks are completed according to deadlines and quality standards.</li>
<li>Establishes effective working relationships with cross-functional team(s)</li>
<li>Collaborates to problem solve and make decisions to achieve desired outcomes</li>
<li>Responds timely, effectively and appropriately to deliverables</li>
<li>Shares knowledge, time and expertise to assist other members of the team</li>
<li>Cultivates and maintains strong customer relationships and rapport with stakeholders and/or client groups</li>
<li>Identifies and responds appropriately to both internal and external customer needs utilizing available resources</li>
<li>Represents the company with external constituents</li>
</ul><p></p><p><b>Physical Demands:</b></p>
<ul><li>Able to perform moderate lifting.</li>
<li>Able to sit, stand and walk for prolonged periods of time.</li>
<li>Able to read papers and online documents.</li>
<li>Able to operate standard office equipment.</li>
<li>Able to exercise physical ability and perspective acuity to satisfactorily perform essential job functions.</li>
</ul><h2 class="jobSectionHeader"><b>About Us</b></h2>
<p>Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars- Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.</p>
<h2 class="jobSectionHeader"><b>About the Team</b></h2>
<p>With a growing number of primary urgent and specialty care locations across Southern California, Cedars-Sinai&rsquo;s medical network serves people near where they live. Delivering coordinated, compassionate healthcare you can join our network of clinicians and physicians to improve the healthcare people throughout Los Angeles and beyond.</p>
</div><div><div><b>Req ID</b> 19244</div> <div><b>Working Title</b> Clinical Research Coordinator III - Cardiology</div> <div><b>Department</b> Cardiology - Towers</div> <div><b>Business Entity</b> Cedars-Sinai Medical Care Foundation</div> <div><b>Job Category</b> Academic / Research</div> <div><b>Job Specialty</b> Research Studies/ Clin Trial</div> <div><b>Overtime Status</b> EXEMPT</div> <div><b>Primary Shift</b> Day</div> <div><b>Shift Duration</b> 8 hour</div> <div><b>Base Pay</b> $85,280 - $132,184</div></div></div><p></p>
<br><div><div><h3 class="jobSectionHeader"><b>Diversity and Inclusion at Cedars-Sinai</b></h3>
<p>We are caretakers and innovators committed to the pursuit of equitable healthcare. But health equity is not possible without representation. Our commitment to diversity goes beyond demographics or checking boxes. Our people must reflect the diverse identities, experiences and geographies of the communities and patients we serve &ndash; because that&rsquo;s what our patients, colleagues and communities deserve Quality Care and Research&mdash;For All, By All.</p>
</div><div><h3 class="jobSectionHeader"><b>Cedars-Sinai is an Equal Employment Opportunity employer.</b></h3>
<p>Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.</p>
<p>Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.</p>
<p>At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy.</p></div></div><p></p>

Clinical Research Coordinator III - Cardiology

Knight Management Insurance Services LLC

<div><p><b>Los Angeles | Hybrid / In-Office Preferred</b></p>
<p><b>
Knight Management Insurance Services LLC</b></p>
<p><b>
Pay Range: </b>$100,000- $120,000 Per Year. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire and will be dependent on a wide range of factors, including but not limited to geographic location, skill set, experience, education, credentials, and licensure when applicable.</p>
<p>
KnightBrook Insurance Company is seeking an experienced <b>Actuarial &amp; Regulatory Filing Specialist</b> to support the development, preparation, submission, and maintenance of personal lines insurance filings. This role combines actuarial support with regulatory filing expertise and will work closely with underwriting, product management, compliance, finance, and executive leadership to ensure timely approval and implementation of rate, rule, and form filings.</p>
<p>
The ideal candidate will have direct experience preparing and managing <b>California Department of Insurance (CDI)</b> and <b>Texas Department of Insurance (TDI)</b> filings for personal auto and homeowners insurance products and be comfortable owning projects from actuarial analysis through regulatory approval.</p>
<p><b>
What You'll Do as an Actuarial &amp; Regulatory Specialist:</b></p>
<p><b>
Actuarial Support</b></p>
<ul>
<li>Prepare actuarial exhibits and supporting documentation for personal lines rate filings.</li>
<li>Analyze rate adequacy, loss trends, premium impacts, and competitive positioning.</li>
<li>Develop and maintain actuarial memoranda supporting rate revisions.</li>
<li>Perform pricing analyses using internal company experience, industry data, catastrophe models, and external benchmarks.</li>
<li>Assist in development of new products, rating plans, territories, and underwriting programs.</li>
<li>Review premium indications and recommend rate changes.</li>
<li>Support implementation and validation of approved rate changes.</li>
</ul>
<p><b>Regulatory Filing Responsibilities</b></p>
<ul>
<li>Prepare, submit, and manage insurance filings through <b>SERFF</b>.</li>
<li>Coordinate <b>rate, rule, and form filings</b> for:</li>
<li><ul><li>Personal Auto</li>
<li>Homeowners</li>
<li>Dwelling Fire</li>
<li>Other personal lines products</li>
</ul></li><li>Respond to regulator objections, information requests, and interrogatories.</li>
<li>Track filing status and regulatory approvals.</li>
<li>Coordinate implementation dates with internal stakeholders.</li>
<li>Maintain filing documentation and historical filing repository.</li>
<li>Prepare filing summaries for executive management.</li>
</ul>
<p><b>Product Development</b></p>
<ul>
<li>Work with Product Management and Underwriting to develop:</li>
<li><ul><li>New insurance programs</li>
<li>Rating variables</li>
<li>Discounts and surcharges</li>
<li>Territory updates</li>
<li>Underwriting guideline changes</li>
</ul></li><li>Coordinate filing implementation with IT and Operations.</li>
</ul>
<p><b>Regulatory Compliance</b></p>
<ul>
<li>Monitor regulatory developments impacting personal lines products.</li>
<li>Assist with market conduct and regulatory examinations.</li>
<li>Ensure products remain compliant with state insurance regulations.</li>
<li>Support audits and internal compliance initiatives.</li>
</ul>
<p><b>Qualifications</b></p>
<p><b>
What do we look for in our Actuarial &amp; Regulatory Specialist?</b></p>
<ul>
<li><b>3&ndash;7+ years</b> of actuarial, product management, or insurance filing experience.</li>
<li>Experience with:</li>
<li><ul><li>California Department of Insurance (CDI)</li>
<li>Texas Department of Insurance (TDI)</li>
</ul></li><li>Direct experience preparing:</li>
<li><ul><li>Rate filings</li>
<li>Rule filings</li>
<li>Form filings</li>
<li>Supporting actuarial memoranda</li>
</ul></li><li>Experience using <b>SERFF</b>.</li>
<li>Experience with personal lines:</li>
<li><ul><li>Personal Auto</li>
<li>Homeowners</li>
<li>Dwelling Fire</li>
</ul></li><li>Familiarity with insurance statutes and regulations governing rate filings.</li>
<li>Bachelor's degree in one of the following:</li>
<li>Actuarial Science</li>
<li>Mathematics</li>
<li>Statistics</li>
<li>Economics</li>
<li>Finance</li>
<li>Data Analytics</li>
<li>Related quantitative discipline</li>
<li>Progress toward actuarial credentials (CAS or ACAS) is preferred but not required.</li>
</ul>
<p><b>Desired Qualifications</b></p>
<ul>
<li>Strong analytical and quantitative skills.</li>
<li>Excellent written communication for regulatory correspondence.</li>
<li>Ability to manage multiple filing projects simultaneously.</li>
<li>Detail-oriented with strong organizational skills.</li>
<li>Ability to communicate effectively with actuaries, underwriters, regulators, executives, and external consultants.</li>
<li>Strong project management capabilities.</li>
</ul>
<p><b>Key Areas of Responsibility</b></p>
<ul>
<li>Personal Auto Rate Filings</li>
<li>Homeowners Rate Filings</li>
<li>Rule Filings</li>
<li>Form Filings</li>
<li>SERFF Submission Management</li>
<li>CDI and TDI Regulatory Correspondence</li>
<li>Product Pricing Analysis</li>
<li>Filing Documentation</li>
<li>Regulatory Compliance</li>
<li>Filing Implementation Support</li>
</ul>
<p><b>Success Measures</b></p>
<p>
The successful candidate will:</p>
<ul>
<li>Deliver timely and accurate actuarial analyses supporting pricing decisions.</li>
<li>Successfully prepare and obtain approval of CDI and TDI filings.</li>
<li>Reduce reliance on outside actuarial consulting firms for routine filing work.</li>
<li>Maintain compliance with all applicable regulatory requirements.</li>
<li>Support profitable growth of KnightBrook's personal lines products through sound actuarial and regulatory practices.</li>
</ul>
<p><b>Preferred Background</b></p>
<p>
Candidates with prior experience at:</p>
<ul>
<li>Property &amp; Casualty insurance carriers</li>
<li>Insurance consulting firms (e.g., Perr &amp; Knight, Milliman, Oliver Wyman, WTW)</li>
<li>State insurance departments</li>
<li>Personal lines product management or actuarial departments will be highly regarded.</li>
</ul>
<p>This role is designed to bring much of the actuarial filing work currently outsourced in-house, enabling KnightBrook to manage routine CDI and TDI rate, rule, and form filings internally while leveraging external consultants only for specialized or large-scale projects.</p>
<p><b>
Benefits</b></p>
<p><b>
What do we offer?
</b></p><ul><li>Medical, Dental, and Vision benefits.</li>
<li>Supplemental life insurance policies for you and your dependents</li>
<li>Long term disability insurance</li>
<li>Flexible Spending Account (FSA)</li>
<li>Employer paid life insurance</li>
<li>Retirement plans: Employer match, 401(k) and Employee Stock Ownership Plan (ESOP)</li>
<li>Metro-link Reimbursement</li>
<li>Career Path Opportunities</li>
<li>Onsite Gym with group Yoga and Pilates; classes</li>
<li>UKG Wallet (access to your pay before payday)</li>
<li>Tickets at Work- Discounts on parks, museums, movie tickets and much more</li>
<li>AT&amp;T Wireless Discounts</li>
<li>Midway Rent a Car- Rental car Discounts</li>
<li>Dell Member Purchase Program</li></ul><p></p><p><br>
Equal Opportunity Employer<br>
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.</p></div>

Actuarial & Regulatory Filing Specialist

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary</b></p><p>
The Senior Investigator, Aetna Special Investigations Unit, will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. This position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes.</p><ul><li>
Investigate matters of program integrity to prevent payment of aberrant claims submitted to the Medicaid lines of business for payment</li><li>
Conduct thorough research on subject(s) and related entities</li><li>
Initiate independently proactive data mining using SIU Tools to identify aberrant billing patterns and early scheme detection</li><li>
Conduct extensive analysis of claims data to determine aberrancy, pattern, or scheme</li><li>
 Research and prepare cases for both clinical and legal review</li><li>
Collaborate with Medical Directors on clinical issues and medical record questions</li><li>
Accurately documents all case activity and communications in designated case tracking system</li><li>
Communicate clinical findings to provider</li><li>
Adherence to all regulatory requirements</li><li>
Facilitate case outcomes for the recovery of company and customer monies lost from aberrant billing</li><li>
Provide training and guidance to new and junior investigators</li><li>
Assist junior Investigators in identifying resources for cases; offer suggestions on investigative strategy</li><li>
Serve as back up to the Team Leader as necessary</li><li>
Collaborate with federal, state, and local law enforcement agencies for the investigation and prosecution of healthcare fraud issues</li><li>
Communicate clearly a high level of FWA knowledge and understanding during interactions with both internal and external stakeholders</li><li>
Experience in witness testimony; Proficient in testifying for both civil and criminal proceedings</li><li>
Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA</li><li>
Communicate ideas on efficiency gains; provides input regarding controls for monitoring FWA among the business segments</li></ul><p></p><p><b>
Required Qualifications</b></p><ul><li>
3+ years investigative experience in healthcare fraud and abuse matters</li><li>
Working knowledge of medical coding; CPT, HCPCS, ICD10</li><li>
Proficient in Microsoft Office with advanced skills in Excel (pivot tables are a must, Power BI, etc.)</li><li>
Strong analytical ability to view and slice claims data in multiple facets</li><li>
Self-starter: initiates research that will be vital to an investigation</li><li>
Proficient in researching information and identifying new resources helpful to all cases</li><li>
Ability to travel up to 10%</li></ul><p><b><br>
Preferred Qualifications</b></p><ul><li>
5+ years investigative experience in healthcare fraud and abuse matters</li><li>
Medicaid/Medicare investigation experience; knowledge of applicable rules and regulations</li><li>
Exercises independent judgement; uses available resources and technology in developing evidence, supporting allegations for fraud and abuse</li><li>
Credentials: Association of Certified Fraud Examiners (CFE) or National Health Care Anti-Fraud Association (AHFI)</li><li>
Knowledge and understanding of complex clinical issues</li><li>
Customer-Focused. Ability to effectively interact and collaborate with various stakeholders and departments to drive solution</li><li>
Strong verbal and written communication skills (using correct grammar, spelling, sentence structure, etc.)</li></ul><p><b><br>
Education</b></p><ul><li>
Bachelor's degree or equivalent experience (5+ of working health care fraud, waste and abuse investigations)</li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$46,988.00 - $112,200.00<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><br>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p><br>
We anticipate the application window for this opening will close on: 08/22/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Senior Investigator, Special Investigations Unit (Aetna SIU)

<div><div><div><div><b>Job ID</b> 18133 <b>Location </b>Los Angeles, California, United States <b>Job Category</b> Clinical Operations <b>Date posted</b> 07/11/2026
</div></div><p></p><div>
</div></div><div><h2 class="jobSectionHeader"><b>Job Description</b></h2>
<div><div>Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation&rsquo;s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company&rsquo;s Workplace of the Year. We provide an outstanding benefit package, along with competitive compensation. Join us! Discover why U.S. News &amp; World Report has named us one of America&rsquo;s Best Hospitals.</div>
</div><div></div><div><div>The International Clinical Coordinator provides vital education and information on available clinical options, the informed decision-making process, and realistic goal setting in order to empower the patient/caregiver to actively participate in their plan of care. They establish and coordinate an encouraging care plan with goals and interventions based upon treatment and individual patient/caregiver needs, preferences, beliefs and values. The Coordinator participates in patient services performance improvement as well as business development initiatives. Works in concert with CSI staff, other CSMC departments (both medical and administrative), outside referral agencies/ companies and guarantors to optimize the patient experience and business health.</div>
 <div></div><div>The Coordinator: Works with a team to implement all steps needed for intake and coordination of international patients (from initial contact through completion of all medical services). The workflow includes triage, request for medical documentation and presentation to specialists based on diagnosis, establishing a plan of care, working with finance to create a self-pay estimate or with international insurance to verify benefits/ obtain authorization, visa support, scheduling, concierge services (providing information about local accommodations/ tourist activities), and participating in discharge planning/ transition of care back to the home country. Interacts with internal and external entities such as embassies, physicians/ CS departments, insurance, and referral agencies. Serves as a resource for questions, concerns, and complaints throughout the patient&rsquo;s medical journey, ensuring all clinical and non-clinical needs are met. Establishes and revises the plan of care for appropriateness on an ongoing and timely basis as advised by the patient&rsquo;s care team. Assists in the development of a comprehensive diagnostic/treatment plan related to the patient's needs, through interdisciplinary input and weekly meetings. Actively participates in patient services, quality, and business development initiatives. Works with a team to monitor Key Performance Indicators and achieve targets as well as support business development initiativ</div>
</div><div></div><h2 class="jobSectionHeader"><b>Qualifications</b></h2>
<p><b>Education</b></p>
<ul><li>Bachelor's Degree Bachelor's of Science, Nursing - minimum</li>
<li>Master's Degree Master&rsquo;s of Science, Nursing - preferred</li><br>
</ul><p><br>
Experience
</p><ul><li>3 years Experience in an acute care setting (transplant, cancer, breast, pre-natal); preferred experience with program development and implementation of navigator programs. - minimum</li><br>
</ul><p><br>
Licenses and Certifications
</p><ul><li>RN State License - Upon Hire minimum Registered Nurse</li>
<li>ANCC Specialty Certification - 1 Year minimum Professional Certification in area of specialty</li>
</ul></div><div><div><b>Req ID</b> 18133</div> <div><b>Working Title</b> Registered Nurse - International Clinical Program Coord - 8 Hour Days</div> <div><b>Department</b> Cedars Sinai International</div> <div><b>Business Entity</b> Cedars-Sinai Medical Center</div> <div><b>Job Category</b> Clinical Operations</div> <div><b>Job Specialty</b> Clinical Operations</div> <div><b>Overtime Status</b> EXEMPT</div> <div><b>Primary Shift</b> Day</div> <div><b>Shift Duration</b> 8 hour</div> <div><b>Base Pay</b> $55.11 - $88.18</div></div></div><p></p>
<br><div><div><h3 class="jobSectionHeader"><b>Diversity and Inclusion at Cedars-Sinai</b></h3>
<p>We are caretakers and innovators committed to the pursuit of equitable healthcare. But health equity is not possible without representation. Our commitment to diversity goes beyond demographics or checking boxes. Our people must reflect the diverse identities, experiences and geographies of the communities and patients we serve &ndash; because that&rsquo;s what our patients, colleagues and communities deserve Quality Care and Research&mdash;For All, By All.</p>
</div><div><h3 class="jobSectionHeader"><b>Our compensation philosophy</b></h3>
<p>We offer a competitive compensation package for our employees. The base pay range shown generally applies to the greater Los Angeles area and may vary based on work location. Our range takes into account the wide range of factors that are considered in making compensation decisions, including knowledge/skills: relevant experience and training, education/certifications/licensure; and other business and organizational factors. The base pay range does not include any incentive payments that may be applicable to a role. Pay Transparency Non-Discrimination Provision (PDF) .</p>
</div><div><h3 class="jobSectionHeader"><b>Cedars-Sinai is an Equal Employment Opportunity employer.</b></h3>
<p>Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.</p>
<p>Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.</p>
<p>At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy.</p></div></div><p></p>

Registered Nurse - International Clinical Program Coord - 8 Hour Days

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