Utilization Management Nurse
Presidential Staffing Solutions, LLC
Benefits: 401(k) Competitive salary Dental insurance Health insurance Paid time off Signing bonus Training & development Vision insurance Location: Outpatient Case Management West Los Angeles VAMC, 11301 Wilshire Blvd, Los Angeles, CA 90073 There are five new RN vacancies at the West Los Angeles VA Medical Center. Job Summary: We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse, you will be responsible for reviewing patient files and treatment methods with an eye for efficiency and effectiveness. Your role will ensure that all patients under our care are receiving the necessary treatments and procedures. The ideal candidate has deep experience in a similar medical setting, a bachelor's or higher in Nursing, and a certification in either Case Management or Utilization Management. Responsibilities: Review patient files and treatment information for efficiency. Monitor the activity of staff to ensure effective patient treatment. Advocate for quality patient care to prevent complications. Review discharge information for outgoing patients. Work closely with clinical staff to provide excellent patient care. Prepare reports on patient management and cost assessments. Qualifications: BSN and/or MSN preferred. Minimum of 5 years of successful nursing practice, encompassing education, administration, leadership, and Quality Management Performance Improvement (QM/PI) experience preferred. Basic computer literacy proficiency with Microsoft Office or comparable software. Ability to work variable and flexible tours to meet program demands. Demonstrated ability to accurately implement policies, regulations, and standards of care. Excellent organizational, communication, writing, and time management skills. Excellent interpersonal skills and the ability to work independently as well as collaboratively. #J-18808-Ljbffr
$74.16 - $107.75 per hour
...Description The Utilization Management (UM) Nurse supports appropriate level‑of‑care determination, patient flow, and revenue cycle integrity across inpatient, partial hospitalization, and intensive outpatient programs. The UM Nurse functions in two utilization management...SuggestedWork at office- ...UCLA Health is seeking a Utilization Management Nurse in Los Angeles, California. This role involves supporting appropriate level-of-care determination, patient flow, and revenue cycle integrity. Responsibilities include performing utilization reviews, tracking authorizations...Suggested
- ...Training & development Vision insurance Outpatient Case Management West Los Angeles VAMC 11301 Wilshire Blvd Los Angeles, CA... ...Opportunities Job Summary We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse on the...SuggestedFor contractorsWork at officeImmediate startRelocation packageMonday to FridayFlexible hours
$41.38 - $69.02 per hour
...Anticipated End Date: 2026-07-10 Position Title: RN Utilization Management Nurse (InPatient) - California HMO Job Description: RN Utilization Management Nurse (InPatient) - California HMO Virtual: This role enables associates to work virtually...SuggestedFull timeTemporary workWork experience placementWork at officeLocal areaShift work1 day per week- ...fifth consecutive Magnet designation for nursing excellence. From working with a team of... ...the UR process as defined in the Utilization Review Plan in accordance with the CMS... ...resource outcomes, and appropriate financial management for the patient and the organization...SuggestedDaily paidSeasonal work
$60 - $75 per hour
...Utilization Management Nurse We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for efficiency and effectiveness. Your...Hourly pay- ...AltaMed in Montebello, California is seeking an LVN Utilization Management Nurse to provide routine reviews of authorization requests. The ideal candidate will have a current valid license as a Vocational Nurse and must possess a minimum of 2 years of managed care experience...
- ...this is more than a job. It’s the calling of our lives and it compels us to keep moving forward. Job Overview The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from all lines of business using respective national/state...Flexible hours
- ...An established industry player in healthcare is seeking a dedicated Utilization Management Nurse to enhance patient care efficiency. In this vital role, you will review patient files and treatment methods, ensuring that every patient receives the necessary treatments...Relocation package
- ...The RN Utilization Management (RN UM) functions as a support liaison for a variety of UM functions which may include the e‑TAR process, denials... .... Position Requirements A. Education Associates Degree in Nursing required. BSN preferred. B. Qualifications/Experience...Full timeLocal area
$99.31k - $131.09k
...providers (internal and external), clinical staff, and others to timely resolve any utilization management issues Job Requirements Minimum of three (3) years of relevant clinical nursing experience Strong preference for prior PACE experience Two (2) years of supervisory...- ...Direct Jobs is seeking a Utilization Management Nurse in Los Angeles, CA, to support level-of-care determination and optimize patient flow. The Nurse will conduct utilization reviews, ensure timely access to care, and work closely with payors and the treatment team. The...
- ...Astrana Health Management is seeking a CA-licensed UM Review Nurse to review outpatient medical services. Candidates should have 1+ years of outpatient Utilization Management experience, work remotely, and maintain availability for shifts 8 AM – 8 PM PST, Monday through...Remote workShift work
- ...L.A. Care Health Plan in Los Angeles is hiring a Utilization Management Claims Review Nurse RN II responsible for conducting clinical reviews of medical claims. The position requires a minimum of 5 years in clinical nursing, with experience in Medi-Cal and Medicare managed...
$112.9k - $256.9k
...career to the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you’ll provide direct management to a team of UM coordinators and nurses. You’ll work closely with Medicare Advantage leadership to plan,...- ...L.A. Care Health Plan is seeking a Supervisor of Utilization Management RN to lead the daily operations of the UM department in Los Angeles. This role requires extensive clinical experience and supervisory skills to ensure department efficiency and quality care delivery...Full time
$74.16 - $107.75 per hour
...Description The Utilization Review Nurse is part of the Utilization Management Department at the Resnick Neuropsychiatric Hospital, supporting inpatient, partial hospital, and intensive outpatient programs. Performs clinical reviews with third party payors in order to...$88.85k
...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13077 Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $14...Full time$35.87 - $47.36 per hour
...Utilization Management LVN Los Angeles, CA, USA At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, while functioning as both a care provider and care plan to we...Work at office$30 - $34 per hour
...A health services company is seeking a Utilization Management Review Nurse in Monterey Park, CA. This hybrid role includes conducting reviews for inpatient admissions and outpatient procedures, ensuring compliance with regulations, and working collaboratively with the...Hourly payWeekend work- ...MedPOINT Management is hiring a UM Outpatient Licensed Clinician in Los Angeles, California. In this role, you'll be responsible for... ...current California RN or LVN license and 2+ years of experience in utilization management are required. Proficiency in Microsoft Office is...Work at office
$74.16 - $107.75 per hour
...Qualifications ~ BSN or MSN, required ~5 years of psychiatric nursing care experience required. ~ Current valid CA RN license, required ~ BLS from the ARC or AHA, required. ~ Prior case management experience, highly desired ~ Proficient in Microsoft Office...Hourly payWork at officeRemote workMonday to Friday- ...Ocean State Job Lot is seeking an RN for Utilization Management in Los Angeles, CA. This role involves coordinating care submissions and documentation... ...efficiency. Candidates must hold an Associate's Degree in Nursing and have experience in Case Management or Utilization...
$116.3k - $264.6k
...UCLA Health is seeking a leader for Intensive Case Management and Utilization Management programs in Los Angeles. This role involves supervising... .... The ideal candidate will have a Bachelor's in Nursing, RN licensure in California, and several years of experience...$102.18k
...Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 9... ...as assigned. Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience...Full time$116.3k - $264.6k
...UCLA Outpatient Clinics is looking for an experienced Utilization Management Assistant Director in Los Angeles. In this key leadership role, you will oversee Intensive Case Management and Utilization Management operations, ensuring high-quality patient care across complex...- ...Martin Luther King, Jr. Community Hospital is looking for a dedicated RN Utilization Management nurse to manage healthcare utilization from admission to discharge. You will coordinate care documentation and work closely with the insurance team to ensure high-quality care...
- ...Martin Luther King, Jr. Community Hospital in Burbank, California, is seeking a Registered Nurse for the RN Utilization Management position. The RN will act as a support liaison for various UM functions including case management and denials management, coordinating care...
$52.25 - $80.99 per hour
...MLK Community Healthcare is looking for an RN Utilization Management to oversee the coordination of care submissions and manage clinical denials. The role requires an Associate's Degree in Nursing, with preference for a BSN, and a California Registered Nurse License....Hourly pay- ...Martin Luther King, Jr. Community Hospital is looking for an RN Utilization Management professional to function as a support liaison for various utilization management tasks, focusing on care coordination from patient admission to discharge. The ideal candidate will possess...
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Management Nurse. Be the first to apply!
- identity management Los Angeles, CA
- director of inventory management Los Angeles, CA
- head of program management Los Angeles, CA
- asset management intern Los Angeles, CA
- director of materials management Los Angeles, CA
- marine resource management Los Angeles, CA
- utilization management nurse Los Angeles, CA
- international management trainee Los Angeles, CA
- threat and vulnerability management engineer Los Angeles, CA
- vice president program management Los Angeles, CA

