RN Utilization Review & Case Management Specialist
$50 - $60 per hourNeier Inc.
Neier Inc. in San Diego, California is seeking a Registered Nurse for utilization review responsibilities. The role includes managing admission reviews, conducting concurrent stay reviews, and preparing payment appeals. Applicants must hold a California RN licence and have experience in case management. The position offers a pay range of $50/hr to $60/hr, along with a comprehensive benefits package including health insurance, 401(k), and tuition reimbursement. #J-18808-Ljbffr Neier Inc.
$50 - $60 per hour
...A healthcare facility in San Diego is looking for a dedicated Utilization Review Nurse to join its team. The role involves conducting admission reviews, managing patient care for both inpatient and outpatient services, and submitting appeals to third party payers. The...SuggestedDay shift$50 - $60 per hour
...-disciplinary treatment team reviewing patient care and treatment options... ...appropriate records of the Utilization Review Department Training:... ...relatively independently, manage multiple tasks, and meet deadlines... ...with Utilization Review-Case Management 401K Retirement Plan...SuggestedFull timeTemporary workWork experience placementWork at officeMonday to Friday- ...for clinical member services review assessment processes.... ...timelines. Refers appropriate cases to medical directors (MDs) and... ...care model. Adheres to utilization management (UM) policies and procedures... ...experience. Registered Nurse (RN). License must be active and...SuggestedRemote jobWork at office
$2,900 - $3,000 per week
Registered Nurse (RN) | Utilization Review Location: California Agency: job.com LLC Pay: Competitive weekly pay (inquire for details) Shift Information... ...support from on-site Clinical Director Requirements RN Case Manager with experience as follows: Must have strong Utilization...SuggestedWeekly payContract workImmediate startMonday to FridayShift work- TravelNurseSource is hiring a Registered Nurse (RN) for Utilization Review in San Diego, California. This position offers a competitive weekly pay of approximately $2,900 to $3,000, with a 13-week contract and guaranteed 40 hours per week. Candidates must have an active...SuggestedWeekly payContract workImmediate startDay shift
$22 - $25 per hour
...Bilingual Case Management Specialist (Remote Flexible, Spanish Speaking) San Diego, California... ...caseload of individuals through the utilization of evidence based approaches to promote... ...by participating in systematic case reviews and consulting with nurse care manager...Full timeWork experience placementLocal areaRemote workWork from homeFlexible hours$18 - $20 per hour
...enjoy more than just a job, you will be empowered to develop and utilize your unique talents and skills to build a rewarding career... ...Behaviors Position Overview: The Transaction Review Specialist (TRS) will be a member of the Transaction Services team. The...Hourly payFull timeTemporary workLocal areaFlexible hoursNight shiftAfternoon shift- ...Molina Healthcare in San Diego, California, is seeking a Clinical Member Services Reviewer to support quality and cost-effective member care. This role requires a minimum of 2 years in healthcare and involves assessing services, analyzing requests, and ensuring compliance...Work at office
- ...Job Title: Emergency Case Management Work and Family Life Specialist (Remote) This is a contingent opportunity and would begin work upon the contract... ...Coordinate and integrate family services and referrals utilizing on‑ and off installation resources, state, intra‑state...Contract workLive inWork at officeLocal areaRemote workWorldwideRelocation packageShift workWeekend work
$20.25 - $36.77 per hour
Job Summary Provides support for facility site review activities including routine document preparation and file management, site review meeting/travel scheduling, and office supply ordering. Facilitates activities including training and reporting, and supports projects...Hourly payWork experience placementWork at office- ...services so individuals no longer need to manage their medical care alone. This... ...the Clinical Services Manager, the RN Case Manager is responsible for... ...medication delivery. Assist with utilization reduction by reviewing hospital documentation for discharge...Daily paidFull timeMonday to FridayFlexible hours
$22 - $25 per hour
...the largest Enhanced Care Management providers in California and... ...of individuals through the utilization of evidence based approaches... ...practitioner and Community Engagement Specialist with delegated tasks... ...in systematic case reviews and consulting with nurse care...Remote jobFull timeWork experience placementLocal areaWork from homeFlexible hours$27.61 - $53.83 per hour
...Provides support for clinical member services review assessment processes. Responsible for... ...timelines. • Refers appropriate cases to medical directors (MDs) and presents... ...the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required...Hourly payContract workWork experience placementWork at office$27.61 - $53.83 per hour
...Provides support for clinical member services review assessment processes. Responsible for... ...required timelines. Refers appropriate cases to medical directors (MDs) and presents... ...the Molina care model. Adheres to utilization management (UM) policies and procedures. Required...Hourly payContract workWork experience placementWork at office- ...educational perspective. Provide group and individual counseling, case management, advocacy, and outreach to clients, and families as... ...to meet client housing needs. QUALIFICATIONS • Peer Specialist Certification required. • High School Diploma or GED required...Contract workWork at officeLocal areaFlexible hoursShift work
- ...business practices. What You Will Do The SRS RN CM II assesses, develops, implements,... ...with regulatory/financial/utilization review demands to assure patients are receiving... ...Years acute care nursing experience or case management experience 3 Years recent case management...Hourly payDaily paidShift workWeekend work
- ...Atlas MedStaff is seeking a CVOR RN for a travel healthcare contract in San Diego, California. In this role, you will provide essential... ...the opportunity to work across orthopedics, neuro, and robotics cases. The contract is for 36 hours per week over approximately 13...Contract workShift work
- ...compliance with care standards, and performing direct nursing duties. Candidates must hold an Associate Degree in Nursing, possess a valid RN license, and have at least one year of nursing experience. The position supports surgical care within a military medical environment....
$55 - $60 per hour
...Hospice Registered Nurse Case Manager - Leadership Role Lead with... ...Are you an experienced Hospice RN who thrives in leadership and... ...Clinical Oversight - Monitor and review patient care, ensuring... ...unique living conditions. Utilize a tablet or laptop for real-time...Hourly payLocal area$144.5k - $175.1k
...strong capability in account management skill sets, superior selling... ...and interacting with HCPs. Utilizing various digital communication... ...number so we can review. Communications related to your... ...5 : Senior Therapeutic Area Specialist, Oncology/ Hematology- San Diego...Hourly payFull timeTemporary workPart timeFor contractorsSummer workPrivate practiceLive inWork at officeLocal areaRemote workFlexible hoursShift work$58.87 - $101.33 per hour
...12/31/2026 JOB SUMMARY: Case Managers function as liaisons between... ...of care, and implementing the utilization management process for acute... ...Managers perform concurrent review and denials management based... ...Heart Association) California RN License Bachelor's Degree...Casual work$90k - $110k
...RN Case Manager Empowering Wellness, Transforming Lives Optima Medical Management Group is dedicated... ...based on medical history, diagnoses, utilization patterns, medications, and risk indicators. Develop, review, and clinically approve individualized ECM care...Full timeTemporary workLocal areaImmediate startFlexible hours$21.5 - $26.25 per hour
...a safe place to sleep. As our Housing Specialist, you are the architect of stability. Partnering... ...The Housing Expert: You aren't just a case manager; you're a navigator. You'll lead... ...laws. For further information, please review the Know Your Rights notice from the Department...Permanent employmentFull timePart timeMonday to Friday$21.5 - $26.25 per hour
...stable housing, reliable benefits, and meaningful work. As a Case Manager Specialist , you are the "go-to" person for a specific specialty. You’... ...to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor....Full timePart timeRelocation packageMonday to Friday- TotalMed is seeking an experienced PCICU travel nurse in San Diego, California. The position requires at least one year of experience in a PCICU or similar critical care setting along with PALS and BLS certifications. As a PCICU Nurse, you will provide critical care to...
$62.4k - $71.65k
...Asset Protection Safety Specialist, Western District... ...Asset Protection Safety Manager DAPSM and Asset Protection... ...complete investigative case files ensuring investigations... ...as warranted. Utilizes Point of Sales POS exception... ...internal review and control techniques...Temporary workFor contractorsSeasonal workWork at officeLocal areaFlexible hoursNight shift- ...gastroenterology. The Revenue Integrity Specialists primary functions are daily management / resolution of revenue capture work queues (Account, Charge Review and Charge Router Review) that are... ...of 1 year experience required in utilization of spreadsheets, graphics, power...Full timeLocal areaRemote work
- ...requirements. Completes all notes and billing daily. Completes all tasks and documentation needs (i.e. utilization management, plan of care, medical necessity reviews) based on department and regulatory requirements. Professional and Departmental Development Identifies...Hourly payPart timeShift work
- ...Position : Complaints Management Specialist - Must SAP, ERP & Order Management (Entry Level) Location... ...quote and order management processes, utilizing various software applications and... ...product and order related information. Reviews custom reagent quote requests and...Contract workDay shift
$18.35 per hour
...enthusiastic and hardworking ECOMMERCE SPECIALIST, you will be responsible for... ...our ecommerce platform. Utilize best practices for title,... ...through effective workload management. Display an eagerness to... ...further information, please review the Know Your Rights ( notice...Full timeWork at officeLocal areaFlexible hoursShift workAfternoon shift
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