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
- ...Job Description The Utilization Review Case Manager is responsible for assessing the medical necessity, appropriateness, and efficiency of patient... ...escalation policies. Uses clinical knowledge and nursing expertise to conduct initial and concurrent reviews for inpatient...SuggestedRemote workShift workNight shift
- ...Job Description Job Description About the Role Join myPlace Health as a Registered Nurse - Utilization Management in Los Angeles, CA. myPlace Health specializes in providing value-based, comprehensive care and coverage for older adults with significant needs, enabling...SuggestedFull time
- ...& development ~ Vision insurance Outpatient Case Management West Los Angeles VAMC 11301 Wilshire Blvd Los Angeles... ...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
- Job Description The Utilization Review Case Manager is responsible for assessing the medical necessity, appropriateness, and efficiency of patient... ...Assoc. Degree/College Diploma Graduate of an accredited nursing program - minimum Bachelor's Degree Nursing - preferred...SuggestedNight shift
- Job TitleWork Location: Los Angeles, CA, USAOnsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8AM - 5PMSalary Range: $98200 - 214600 AnnuallyEmployment Type: 2 - Staff: Career Duration Indefinite Job # 32733Primary Duties And ResponsibilitiesPress space or...SuggestedRemote workMonday to FridayFlexible hours
$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$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- L.A. Care Health Plan in Los Angeles, CA is seeking a Utilization Management (UM) Claims Review Nurse RN II to evaluate medical claims for medical necessity, documentation, and proper coding. This role supports payment integrity through pre-payment and retrospective reviews...
- NeueHealth seeks a full-time Utilization Management (UM) Prior Authorization (PA) Nurse in California. You will review and authorize prior authorizations for treatments, medications, and tests, ensuring alignment with contract requirements, coverage policies, and medical...Remote jobFull timeContract work
$31.05 - $38.82 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$26.35 - $39.53 per hour
...better care experience for all. SCOPE OF ROLE The role of the UM Nurse is to promote quality, cost-effective outcomes for a population... ...to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned. EDUCATION...Hourly payContract workFor contractorsFor subcontractorWork at office$98.2k - $214.6k
Job Title Work Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8AM - 5PM Salary Range: $98200 - 214600 Annually Employment Type: 2 - Staff: Career Duration Indefinite Job # 32733 Primary Duties And Responsibilities...Remote workMonday to FridayFlexible hours- ...indirect caregiver, patient advocate and manages patients in the most cost effective way... ...providing continuity of care, including Utilization management, Transfer coordination, Discharge... ..., Registration Registered Nurse License (California) Basic Life Support...Daily paidLocal areaShift workWeekend work
- Kaiser Permanente is seeking a Registered Nurse specialized in utilization management to coordinate admissions and discharge planning in Los Angeles. This role emphasizes patient advocacy in a fast-paced setting and requires strong collaboration with physicians and the...Full time
- ...Registered Nurse - ICUDuration: 26 Weeks Start: 12/27/2024 Job Type: Travel Minimum Guaranteed... ...care with other disciplines while utilizing critical thinking, professional and supervisory... ..., Equity, and Inclusion (DEI). We have managed and Implemented Talent Acquisition and...Contract workWork experience placement
- ...Hospice Nurse Schedule After your orientation period - your typical schedule will be... ...1 hour, but if there is active symptom management, visits may take longer to ensure comfort... ...Must be able to assess patients and to utilize sight to implement and evaluate Plan of...Temporary workMonday to FridayFlexible hoursRotating shift
$88.85k
...Utilization Management Nurse Specialist RN II (Outpatient) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health...Full time- ...Job Description Job Description Job Description: Manager of Clinical Utilization Management - Denial ComplianceLocation: Burbank, CAPosition... ...Qualifications:1. Graduate from an accredited Registered Nursing Program; RN preferred.2. Minimum of five years in prior-...Permanent employmentFull timeTemporary workRemote workFlexible hours
- ...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
- ...Registered Nurse - Case Management We have a new opening for a Registered Nurse - Case Management at Luke AFB in Glendale, Arizona. Provides... ...the most beneficial, cost-effective health care. Develops, utilizes and maintains a variety of military and community resources...Temporary workLocal areaMonday to Friday
- AvoCare Palliative- Part Time Registered Nurse-Bilingual/Spanish# AvoCare Palliative-... ...comprehensive care that focuses on comfort, symptom management, and emotional well-being. We are... ...priorities and maintains productivity utilizing time management.· Provides appropriate...Permanent employmentFull timePart timeImmediate startFlexible hours
- Hospice Nurse Schedule After your orientation period - your typical schedule will be... ...1 hour, but if there is active symptom management, visits may take longer to ensure comfort... ...Must be able to assess patients and to utilize sight to implement and evaluate Plan of...Temporary workMonday to FridayFlexible hoursRotating shift
- Cedars-Sinai is seeking an Utilization Review Case Manager to assess medical necessity and optimize patient care. You will collaborate with physicians... ...setting. Ideal candidates bring 3+ years of acute nursing and 2+ years in case management, with strong clinical judgment...
- ...Job Description UM Audit & Compliance Nurse (LVN/RN) – MSO/IPA - HYBRID Location:... ..., California Industry: Healthcare / Managed Care Employment Type: Part time - Hybrid... ...Nurse (LVN/RN) to oversee our Utilization Management, Case Management, and Quality...Part time
- ...performing vital signs and consulting with physicians when necessary. \nCompany Description Progressive Company that utilizes employee feedback and management techniques to improve delivery of service. Company Description Progressive Company that utilizes employee...Full time
- ...to support care coordination for seniors via telephonic care management. You will conduct assessments, develop plans of care, and coach... ...compliance, and collaboration with interdisciplinary teams to improve outcomes and reduce hospital utilization. #J-18808-Ljbffr...
$30 - $34 per hour
...Dr., Monterey Park, CA 91754 Compensation: $30.00 - $34.00 / hour Department: Health Services (HS - UM) Job Title Utilization Management Review Nurse About the Role Astrana Health is looking for a Utilization Review Nurse to assist our Health Services Department. This...Hourly payWork at officeMonday to FridayShift work$47.2 - $63.45 per hour
...Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the... ...years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license # At least one...Full timePart timeWork experience placementLocal areaShift workAfternoon shift- ...Case Manager Cedars-Sinai has been named to the Honor Roll for the ninth consecutive... ...evidence based review guidelines to conduct utilization review as is appropriate to match the... ...patients who are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner...Daily paidSeasonal workDay shift
$47.2 - $63.45 per hour
...Job Description Responsible for the quality and resource management of all patients that are admitted to the facility from the point... ...years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license At least one...Full timePart timeWork experience placementLocal areaShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Management Nurse. Be the first to apply!
- internship event management company Los Angeles, CA
- materials management associate Los Angeles, CA
- entry level emergency management Los Angeles, CA
- pest management Los Angeles, CA
- identity management Los Angeles, CA
- director of inventory management Los Angeles, CA
- managing broker Los Angeles, CA
- management fast track program Los Angeles, CA
- nonprofit management Los Angeles, CA
- logistics and supply chain management Los Angeles, CA



