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
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