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
- ...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
$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...SuggestedHourly pay- ...Utilization Review Nurse Attention military affiliated job seekers - Our organization works with partner companies to source qualified talent... ...clinical resource outcomes, and appropriate financial management for the patient and the organization. National Guard Employment...Suggested
- ...Clinical Case Manager Opportunity Are you ready to bring your expert clinical skills... ...fifth consecutive Magnet designation for nursing excellence. From working with a team of... ...Follow the UR process as defined in the Utilization Review Plan in accordance with the CMS Conditions...SuggestedDaily paidSeasonal work
- The Utilization Management Policy Initiatives Nurse RN II, under the purview of the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating Healthcare Services clinical policies, guidelines, protocols and related...Suggested
- ...in a stressful environment and take appropriate action. Required Work Experience: Two (2) years of nursing experience. One (1) year of experience in utilization management or case management preferred. Other Information: Certification in utilization management and/or...Daily paidWork experience placement
- ...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
$88.85k
...income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of medical claims to ensure services were medically...Full time$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$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...$51 per hour
Health Advocates Network, Inc. is seeking a Registered Nurse to work at a facility in Los Angeles, California. This full-time,... ...with day shifts and a pay rate of $51 per hour, focused on Utilization Management. Candidates with 2+ years of Utilization Management or Case...Hourly payFull timeDay shift- 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 and...Relocation package
- Working Nurse is looking for an RN Utilization Management to coordinate care and manage clinical denials in Los Angeles. The role requires an Associate’s Degree in Nursing and a California RN License, along with experience in Case Management or Utilization Management. This...Day shift
$2,065 - $2,160 per week
...Registered Nurse (RN) | Utilization Review Location: Burbank, CA Agency: GQR Healthcare Pay: $2,065 to $2,160 per week Shift... ...RN in Burbank, California, 91505! Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location:...Hourly payWeekly payFull timeContract workImmediate startShift work$51 per hour
...Registered Nurse (RN) | Administration / Management Location: Los Angeles, CA Agency: Health Advocates Network Pay: Competitive weekly... ...hours ~ Days Nursing Specialty: ~ Utilization Management Qualifications: Ensure...Weekly payFull timeImmediate startMonday to FridayShift work$2,065 - $2,160 per week
...Registered Nurse (RN) | Utilization Review Location: Burbank, CA Agency: GQR Healthcare Pay: $2,065 to $2,160 per week Shift... ...Date: ASAP About the Position Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location:...Hourly payWeekly payFull timeContract workImmediate startShift work$102.18k
...Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position... ...as assigned. Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience...Full time$31.93 per hour
...despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from all lines of business using respective national/...Hourly payFlexible hours- MDAEdge in Los Angeles is seeking a Utilization Management Policy Initiatives Nurse RN II, responsible for managing and creating clinical policies in compliance with state and federal regulations. The ideal candidate will have a strong background in clinical nursing and...
- 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...
$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. Responsibilities...Hourly pay- 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
$88.85k
...Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US,... ...patient placement. (10%) Applies clinical expertise and the nursing process to triage and prioritize admission acuity, servicing...Full time- The University of California - Los Angeles Health is looking for a dynamic Utilization Management Assistant Director to supervise Intensive Case Management and Utilization Management operations. This role involves leading a multidisciplinary team to improve patient outcomes...
- L.A. Care Health Plan in Los Angeles is seeking a Utilization Management Admissions Liaison RN II responsible for overseeing inpatient admission... ...experience in an acute hospital setting and hold a nursing degree. This role is critical in ensuring timely and accurate...
$116.3k - $264.6k
...centered care. UCLA Health is seeking a dynamic and experienced Utilization Management Assistant Director to oversee Intensive Case Management (ICM... ...and mentor a multidisciplinary team including Registered Nurses, Social Workers, and care coordination staff Oversee care...Work at office$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...Work at office- ...Registered Nurse - ICU Duration: 26 Weeks Start: 12/27/2024 Job Type: Travel Minimum... ...coordinates care with other disciplines while utilizing critical thinking, professional and... ...Diversity, Equity, and Inclusion (DEI). We have managed and Implemented Talent Acquisition and...Contract workWork experience placement
$84.07k - $163.93k
...DESCRIPTION Job Summary Leads and manages multidisciplinary team of healthcare services... ...following functions: care management, utilization management, behavioral health, care... ...leadership experience. • Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed...Contract workWork experience placementWork at officeLocal area- ...Registered Nurse - ICU Duration:26 Weeks Start:12/27/2024 Job Type: Travel... ...coordinates care with other disciplines while utilizing critical thinking, professional and... ...Diversity, Equity, and Inclusion (DEI). We have managed and Implemented Talent Acquisition and...Contract workWork experience placement
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