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.
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the RN Utilization Review & Case Management Specialist in San Diego, CA vacancy
$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. Benefits 401(k) Retirement...SuggestedFull timeTemporary workWork experience placementWork at officeMonday to Friday$64.74 - $79.23 per hour
..., patient advocate and manages patients in the most cost... ...community agencies. Reviews, monitors, evaluates and... ...continuity of care, including Utilization management, Transfer... .../agencies and provides case management to patients... ...Two (2) years combined RN experience in an acute...SuggestedFull timeContract workWork experience placementLocal areaShift work- ...PACE Resource Management, RN Under the direct supervision... ...and on-going basis, reviewing claims for services... ...reviews for medication utilization rates and costs,... ...testing, referrals to specialists, durable medical equipment... ...evaluates individual cases and provides feedback...SuggestedWork at office
$25.5 - $31.55 per hour
...adult care, chronic disease management, pediatrics, comprehensive women... ...obstetrics, dental, vision, case management, physical... ...charts for upcoming visits; reviewing for open orders, incomplete documentation... ...at relatively high speed, utilizing grammar and spell check software...SuggestedWork experience placementLocal areaFamily Health Centers of San Diego
Chula Vista, CA19 hours ago$22 - $25 per hour
...of the largest Enhanced Care Management providers in California and... ...practitioner, and Community Engagement Specialist with delegated tasks.... ...participating in systematic case reviews and consulting with nurse... ...and internal providers. Utilize external and internal online...SuggestedFull timeWork experience placementLocal areaRemote workWork from homeFlexible hoursPair Team
San Diego, CA2 days ago$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 hoursPair Team
San Diego, CA3 days ago$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... ...and Leadership 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- Kaiser Permanente in San Diego is seeking a Registered Nurse for Utilization Management to coordinate admissions, screen for medical necessity, and... ...role requires strong nursing experience in acute care or case management, plus knowledge of regulations and patient...
$84.07k - $163.93k
...California license, 2-3 years case management exprience reside in the... ...functions: care management, utilization management, behavioral health... ...completion of staff quality audit reviews evaluates services provided,... .... • Registered Nurse (RN), Licensed Vocational Nurse...Contract workWork experience placementWork at officeLocal areaMolina Healthcare
San Diego, CA2 days ago- ...SummaryThe Registered Nurse (RN) is guided by the policies and... .... The Registered Nurse (RN) utilizes the nursing process to assess... ...organization as needed.Assists with review of in-baskets for laboratory... ...neededWorks closely with the Case Management and Home Care staff to ensure...Work at officeImmediate start
DAP Health
El Cajon, CA3 days ago - ...services so individuals no longer need to manage their medical care alone. This is a... ...the Clinical Services Manager, the RN Case Manager is responsible for... ...and medication delivery. Assist with utilization reduction by reviewing hospital documentation for discharge...Full timeMonday to FridayFlexible hours
St. Paul's Senior Services
San Diego, CA19 hours ago $90k - $110k
...RN Case ManagerEmpowering Wellness, Transforming LivesOptima Medical Management Group is dedicated to enhancing the quality of life by promoting... ...medical history, diagnoses, utilization patterns, medications, and risk indicators.Develop, review, and clinically approve...Full timeTemporary workLocal areaImmediate startFlexible hoursSerene Health Services
San Diego, CA19 hours ago$90k - $104k
Overview Senior Leave of Absence Specialist. Applies advanced knowledge of job protected leaves to manage the leave of absence (LOA)... ...Handles complex or escalated case management to provide consultation... ..., 8 hrs/day, Mon-Fri Initial Review Date: Tue 9/2/2025 Job...Hourly payShift workAfternoon shift- ...caseload of individuals through the utilization of evidence based approaches... ...Plan Supports nurse care manager, behavioral health care... ...practitioner and Community Engagement Specialist with delegated tasks... ...of general work experience (Case Management preferred) You are...Work experience placement
$18 - $20 per hour
ecoATM is seeking a Transaction Review Specialist to ensure the accuracy of consumer transactions in the ecoATM database. This full-time role requires a flexible schedule, including nights and weekends, and involves detailed data review and report generation for law enforcement...Hourly payFull timeFlexible hoursNight shift$55 - $65 per hour
...Are you an experienced Hospice RN who thrives in leadership and... ...a Hospice Registered Nurse Case Manager to oversee patient care, mentor... ...Oversight - Monitor and review patient care, ensuring compliance... ...unique living conditions. Utilize a tablet or laptop for real-time...Hourly payContract workFor contractorsFor subcontractorWork at officeLocal area$55 - $65 per hour
...Hospice Registered Nurse Case Manager Location: North County, San Diego... ...you an experienced hospice RN who thrives in leadership and... ...Oversight Monitor and review patient care, ensuring compliance... ...unique living conditions. Utilize a tablet or laptop for real-time...Hourly payLocal area- ...SRS RN CM II Hours: Shift Start Time: 7:30 AM Shift End Time: 4 PM... ...considerations with regulatory/financial/utilization review demands to assure patients are receiving... ...acute care nursing experience or case management experience ~3 Years recent case management...Hourly payDaily paidShift workWeekend work
- ...build a high-impact Care Management program in a value-... ...We’re hiring a hands‑on RN leader to build and lead... ...This is not a traditional case management role. We are... ...in quality, utilization, and patient outcomes—particularly... ...utilization management reviews Analyze utilization...Contract workRemote workFlexible hoursAfternoon shift
- ...The RN is responsible for assessing patient health problems and needs, developing... ...maintenance and disease prevention or provide case management. Licensing or registration required.... ...tasks, including vital signs and medication reviews Coordinate with physicians,...Local area
Pathwell Health
San Diego, CA2 days ago $30.37 - $59.21 per hour
...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... .... • Registered Nurse (RN). License must be active and...Hourly payWork experience placementWork at officeMolina Healthcare
La Mesa, CA2 days ago- ...Overview Your Role The Utilization Management team independently manages complex... ...and retrospective clinical reviews across multiple lines of business... ...escalation of high-risk cases. Our leadership model is... ...Maintain active, unrestricted RN License in assigned states or...Full timeWork at office
Blue Shield of CA
San Diego, CA4 days ago $85k - $95k
ICF's Disaster Management Division seeks a Senior Grants Specialist to support clients in implementing federally- and state... ...budget tracking, expenditure review, and financial reconciliation activities... ...with stakeholders and staff utilizing excellent communication skills,...Full timeContract workFor contractorsWork experience placementLocal areaRemote workWork from home$23 - $37.81 per hour
...medications before administration utilizing the order as entered into the... ...valid IV certification) Review patient record and forms for... ...May assist in the case management of patient populations May... ...immunizations inventory Report to RN or Nurse Manager when equipment...Hourly payFull timeWork at officeDAP Health
El Cajon, CA4 days ago$30 - $35 per hour
...Department: Enhanced Care Management (ECM) Reports To:... ...Registered Nurse Clinical Case Consultant... ...reconciliation activities under RN supervision. Educate... ...Motor Vehicle Report (MVR) review. Preferred... ...Pacific Health Group utilizes AI-assisted tools to support...Hourly payTemporary workWork at officeLocal areaRemote workMonday to FridayFlexible hoursAfternoon shiftPacific Health Group
San Diego, CA2 days ago- ...operate the largest private utility helicopter fleet in the world... ...an experienced Field Safety Specialist to support our utility powerline... ...coordinating landing zones, managing traffic control, conducting hazard... ...qualifications will be reviewed.• Minimum 3-5 years of experience...Contract workFor contractorsLocal area
$72 per hour
...Nurse Med/Surg-Tele The Med/Surg-Tele RN provides professional nursing care to... ...patients in an acute care hospital setting, utilizing the nursing process in accordance with... ...physicians, charge nurses, ancillary staff, case management, and other interdisciplinary team...Daily paidContract workTemporary workLocal areaImmediate startFlexible hoursShift workNight shiftWeekend work- ...an exciting opportunity for a UAV System Specialist in our Engineering Field Support... ...Under general supervision with limited review, this position will report to the Field... ...analyze, and determine rework direction by utilizing standard engineering and scientific principles...Full timePart timeWork at officeLocal areaRemote workRelocation package
General Atomics
San Diego, CA1 day ago $23 per hour
...The Asset Protection Specialist is primarily responsible... ...multiple stores. They utilize tools to minimize loss... ...of theft and fraud, reviewing CCTV and exception reports... ...accurate and detailed case reports documenting... ...unsafe condition to the Manager on Duty and carry out...Local areaHome Depot
San Diego, CA4 days ago$20 - $27 per hour
...financing for our customers, utilizing the best terms available while... ...Summary The Bankruptcy Specialist plays an important role by preparing... ...packages to attorneys for review and approval. Additionally, responds... .... Essential Functions Manage Bankruptcy portfolio on an independent...Minimum wageWork experience placementWork at officeLocal areaMonday to FridayGuild Mortgage
San Diego, CA1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Utilization Review & Case Management Specialist. Be the first to apply!
Related searches
- unique rn San Diego, CA
- med surg medical surgical rn registered nurse San Diego, CA
- travel registered nurse rn San Diego, CA
- rn outpatient surgery San Diego, CA
- cath-lab rn San Diego, CA
- behavioral rn San Diego, CA
- injection rn San Diego, CA
- pediatric icu rn San Diego, CA
- private rn San Diego, CA
- rn evening shift San Diego, CA