Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Utilization Management RN II — Care Coordination

L.A. Care Health Plan

L.A. Care Health Plan in Los Angeles, CA seeks an Utilization Management Nurse Specialist RN II to coordinate and approve referrals that meet criteria. You will monitor inpatient admissions, conduct telephonic or onsite reviews, and collaborate with on-site staff to discharge patients effectively. Ideal candidate has 5+ years RN experience, 2+ years UM/CM in hospital or HMO, and CA RN license; Bachelor's in Nursing preferred. #J-18808-Ljbffr L.A. Care Health Plan

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Utilization Management RN II — Care Coordination in Los Angeles, CA vacancy
  •  ...Nurse in Los Angeles is seeking an experienced Utilization Management Nurse Specialist RN II for a full time role. You will coordinate and approve medically necessary referrals,...  ...strong UM/CM experience and a solid acute care RN background. The role also involves handling... 
    Suggested
    Full time

    Working Nurse

    Los Angeles, CA
    3 days ago
  • $88.85k

     ...Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location...  ...(Max.) Established in 1997, L.A. Care Health Plan is an independent public...  ...care team for facilitation/coordination of patient transfers between acute... 
    Suggested
    Full time
    Night shift

    LOS Angeles Care Health Plan

    Los Angeles, CA
    2 days ago
  • $88.85k

    RN Job Utilization Management Admissions Liaison RN II (Nights) Shift Full Time Nights Pay Range $88,854.00 (Min.) - $1...  ...admission requests and higher level of care (HLOC) transfer requests from...  ...care team for facilitation/coordination of patient transfers between acute... 
    Suggested
    Full time
    Shift work
    Night shift

    Working Nurse

    Los Angeles, CA
    5 days ago
  •  ...Nurse in Los Angeles, CA is seeking an RN II for Nights to manage utilization management admissions and transfer...  ..., timely determinations, and coordination with inpatient teams. The candidate...  ...in Nursing with 7+ years of acute care experience; Bachelor's in Nursing is... 
    Suggested
    Full time
    Night shift

    Working Nurse

    Los Angeles, CA
    5 days ago
  • $88.85k

     ...Utilization Management Nurse Specialist RN II (Outpatient) Job Category: Clinical Department: Utilization Management...  ...(Max.) Established in 1997, L.A. Care Health Plan is an independent...  ...Nurse Specialist RN II facilitates, coordinates, and approves medically necessary... 
    Suggested
    Full time

    LOS Angeles Care Health Plan

    Los Angeles, CA
    20 hours ago
  • L.A. Care Health Plan in Los Angeles, CA seeks a Utilization Management Nurse Specialist RN II to facilitate and approve referrals that meet criteria, coordinate admissions, and advise on discharge planning. You will work with the UM Manager and Physician Advisor, handle... 

    L.A. Care Health Plan

    Los Angeles, CA
    4 days ago
  • $88.85k

    RN Job Utilization Management Nurse Specialist RN II Shift: Full Time Pay Range: $88,854.00 (Min.) - $115,509.00 (Mid...  ...Nurse Specialist RN II facilitates, coordinates, and approves medically necessary...  ...HMO setting. Preferred Managed Care experience performing UM and CM... 
    Full time
    Shift work

    Working Nurse

    Los Angeles, CA
    3 days ago
  • $88.85k

     ...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017...  ...Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by... 
    Full time

    L.A. Care Health Plan

    Los Angeles, CA
    2 days ago
  • LA Care Health Plan is seeking an RN II for Managed Long-Term Services and Supports in Los Angeles. The nurse specialist...  ...advanced clinical judgment to coordinate physical and behavioral...  ...collaboration with providers to promote utilization of services such as CBAS, SNF, ICF... 

    Working Nurse

    Los Angeles, CA
    3 days ago
  •  ...Angeles is seeking a Registered Nurse to work in Utilization Management and discharge planning. The role collaborates with an MD to coordinate admission decisions, plan safe transitions,...  ...a fast-paced environment, and a California RN license with BLS. Work settings are onsite... 
    Full time

    Kaiser Permanente

    Los Angeles, CA
    3 days ago
  •  ...Allocation Transplant Coordinator II Develops and maintains...  ...practice standards of care for a specific...  ...Demonstrates competence and management in the care of people...  ...program's local network, utilizing the Cerner platform...  ...Req Registered Nurse - RN (CA DCA) Req Basic... 
    Full time
    Local area
    Night shift

    University of Southern California (USC)

    Los Angeles, CA
    4 days ago
  •  ...experienced Registered Nurse Case Manager to collaborate with a physician group to coordinate admissions and discharge planning...  ...recommend appropriate levels of care, and ensure timely, cost-effective...  ...fast-paced environment, and a CA RN license with BLS. #J-18808-... 

    Kaiser Permanente

    Los Angeles, CA
    4 days ago
  • $67.5 - $75 per hour

    VetJobs is seeking a Utilization Review Case Manager in Los Angeles, CA to assess medical necessity and care levels using InterQual, MCG, and...  ...collaborate with physicians, care coordinators, and payers to secure...  ...The ideal candidate has an RN license, 3 years of acute nursing... 
    Hourly pay
    Night shift

    VetJobs

    Los Angeles, CA
    3 days ago
  • SCAN Health Plan seeks a seasoned RN to support care coordination for seniors via telephonic care management. You will conduct assessments, develop plans of care, and...  ...teams to improve outcomes and reduce hospital utilization. #J-18808-Ljbffr SCAN Health Plan
    Remote job

    SCAN Health Plan

    Los Angeles, CA
    1 day ago
  • L.A. Care Health Plan is hiring an RN II for Delegation Oversight Clinical Audit to ensure UM compliance across...  ...and vendors to improve access and utilization performance. The position requires...  ...years of clinical experience (3 in managed care). It offers a comprehensive... 

    L.A. Care Health Plan

    Los Angeles, CA
    1 day ago
  • Pipeline Health, LLC in Huntington Park, CA is seeking a Registered Nurse II for full-time support across shifts with weekend availability. The RN coordinates patient care, leads, and educates patients and families within a high-volume clinical setting. The Nurse II will... 
    Full time
    Shift work
    Weekend work

    Pipeline Health, LLC

    Huntington Park, CA
    2 days ago
  • 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... 

    L.A. Care Health Plan

    Los Angeles, CA
    5 days ago
  • $88.85k

    RN Job Managed Long Term Services and Supports Nurse Specialist RN II Shift Full Time Pay Range $88,854.00 (Min.) - $115,509...  ...and social services for L.A. Care members. Utilizes assessments, member-...  ...planning, direct provider coordination/collaboration and psychosocial... 
    Full time
    Shift work

    Working Nurse

    Los Angeles, CA
    3 days ago
  •  ...Santa Monica, CA is hiring a full-time Care Manager RN. The Inpatient Care Manager delivers...  ...environment, including assessment, planning, coordination of care, discharge planning and...  ...experience and 1 year in care management or utilization review; TIPS or #J-18808-Ljbffr... 
    Full time

    Providence Health & Services

    Santa Monica, CA
    2 days ago
  • L.A. Care Health Plan in Los Angeles is seeking a Utilization Management Admissions Liaison RN II responsible for overseeing inpatient admission requests and transfers. Candidates should have at least 7 years of clinical experience in an acute hospital setting and hold... 

    L.A. Care Health Plan

    Los Angeles, CA
    1 day ago
  •  ...experienced Registered Nurse Case Manager to join our care-team. You will lead care coordination across disciplines and optimize patient...  ...transfers, monitoring resource utilization, and ensuring regulatory compliance. BSN preferred; RN license required; case management certification... 

    Nwregionalheart

    Los Angeles, CA
    2 days ago
  •  ...a Registered Nurse for Case Management to coordinate ED and inpatient transitions...  ...ensure appropriate levels of care, and collaborate with the...  ...planning, and efficient resource utilization in both ED and inpatient...  ...candidates will hold an active RN license in California with... 

    Adventist Health

    Montebello, CA
    2 days ago
  •  ...RN Care Coordinator As our RN Care Coordinator, you will be a central figure in patient care...  ...progression of care and appropriate utilization of inpatient resources using established...  ...or a Masters degree in Case Management or Nursing field in lieu of 1 year experience... 
    Relocation package

    Common Spirit Health

    Los Angeles, CA
    4 days ago
  • $88.85k

     ...Clinical Policy Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition...  ...$142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency... 
    Full time
    Local area

    LOS Angeles Care Health Plan

    Los Angeles, CA
    20 hours ago
  •  ...Angeles seeks an experienced nurse case manager to assess and coordinate care for diverse patients. You will...  ...Responsibilities include risk stratification, utilization review, discharge planning, and...  ...applicants will have BSN or MSN, CA RN license, BLS, and 3+ years in acute... 

    University of California - Los Angeles Health

    Los Angeles, CA
    4 days ago
  • Alta Hospital seeks an experienced RN Case Manager to perform clinical assessments, utilization review, and discharge planning for acute inpatients. You will coordinate care with the interdisciplinary team to promote safe, cost-effective transitions and advocate for patient... 

    Southern California Hospitals

    Los Angeles, CA
    3 days ago
  •  ...in Los Angeles, CA seeks an experienced RN Case Manager for Complex Cases at Santa Monica location. You will assess and coordinate care for a diverse patient group, collaborating...  ...risk stratification tools, perform utilization reviews, and contribute to performance improvement... 

    Working Nurse

    Los Angeles, CA
    2 days ago
  • Kennedy Care Center is seeking an RN Supervisor to lead nursing operations, coordinate care plans, and support residents and families with compassionate, compliant care...  .... The role emphasizes timely documentation, utilization reviews, and collaboration with physicians... 

    Kennedy Care Center in

    Los Angeles, CA
    2 days ago
  •  ...California - Los Angeles Health is seeking a Nurse Case Manager to assess and coordinate care for a diverse patient population. You will collaborate...  ...high-quality, cost-effective care. You will also conduct utilization review and support post-hospital care while driving... 

    University of California - Los Angeles Health

    Los Angeles, CA
    3 days ago
  •  ...the gold standard of patient care we strive for. What will you...  ...role: The Clinical Program Coordinator, RN, provides vital education and...  ...at weekly meetings. Manages clinical data throughout all...  ...collaborative research and utilizing education and clinical research... 
    Live in
    Local area
    Remote work
    Relocation

    Cedars-Sinai

    Los Angeles, CA
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Utilization Management RN II — Care Coordination. Be the first to apply!