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

RN Utilization Review & Quality Assurance Specialist

Emanate Health

Join a leading health care system recognized for excellence, where your role as a Utilization Review Nurse will be pivotal in evaluating medical records and ensuring the delivery of quality care. In this position, you will apply your clinical acumen to assess medical necessity and support medical claims, all while being part of a dedicated team that values community impact and individual growth. With a strong emphasis on collaboration and excellence, this is an opportunity to contribute to a top-ranked health care organization while enhancing your professional skills in a supportive environment. #J-18808-Ljbffr Emanate Health

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the RN Utilization Review & Quality Assurance Specialist in Covina, CA vacancy
  • $52.03 - $80.64 per hour

    Job Summary The Utilization Review Nurse will evaluate medical records to determine medical necessity...  ...management experience. Experience in quality- related job preferred. Computer proficiency...  ...Minimum License Requirement California RN license. Pay Range $52.03 - $80.64 #J-... 
    Suggested
    Full time

    Dormont Manufacturing Co

    Covina, CA
    1 day ago
  • Dormont Manufacturing Co is looking for a Utilization Review Nurse in Covina, California. This role...  ...ideal candidate will have a California RN license, a minimum of three years of utilization...  ...skills. Join our team to contribute to quality patient care and medical claims review.... 
    Suggested

    Dormont Manufacturing Co

    Covina, CA
    1 day ago
  • $31.03 - $46.54 per hour

     ...States, and the #19 ranked company in the country.Job SummaryThe Utilization Review Nurse will evaluate medical records to determine medical...  ...years of utilization management experience. Experience in quality- related job preferred. Computer proficiency is required. Excellent... 
    Suggested
    Full time

    Emanate health

    Covina, CA
    3 days ago
  • $31.03 - $46.54 per hour

     ...the #19 ranked company in the country. Job Summary The Utilization Review Nurse will evaluate medical records to determine medical...  ...three years of utilization management experience. Experience in quality- related job preferred. Computer proficiency is required.... 
    Suggested
    Full time
    Local area

    Emanate Health

    Covina, CA
    1 day ago
  • Dormont Manufacturing Co in Covina, California, is seeking a Utilization Review Nurse to evaluate medical records for necessity and provide...  ...skills and be proficient in computer use. Join us in ensuring quality care and adherence to clinical guidelines. #J-18808-Ljbffr... 
    Suggested

    Dormont Manufacturing Co

    Covina, CA
    1 day ago
  • An established industry player in health care is seeking a Utilization Review Nurse to join their dedicated team. In this vital role, you will evaluate medical records and apply clinical expertise to ensure the delivery of necessary health services. Your contributions... 

    Emanate Health

    Covina, CA
    5 days ago
  • Akido Labs is looking for a Clinical Review Nurse in California to manage prior authorization requests....  ...candidate will possess an active California LVN or RN license and have 3-5 years of experience in clinical utilization management. Key responsibilities include... 

    Akido Labs

    Chino, CA
    3 days ago
  • $78k

    We are currently looking for a qualified EMHS Quality Assurance Specialist to join our Mental Health team. The EMHS Quality Assurance Specialist...  ...of the Mental Health Services Program, including utilization review coordination and continuous quality improvement services... 
    Local area

    Trinity Youth Services

    Claremont, CA
    5 days ago
  • $123.93k - $160.38k

     ...improving the lives of patients for generations to come.  As a Senior Quality Assurance Specialist at Gilead you will have the following responsibilities:Manages, prioritizes, and participates in batch record review and release activities, including review of manufacturing,... 
    Full time
    For contractors
    Local area

    GILEAD Sciences

    La Verne, CA
    4 days ago
  •  ...Job Title: Quality Assurance Specialist Location: Pomona, CA Pay Range: $21 to $25/hr on W2 Job Details: Carry out daily operations...  ...accuracy and efficiency. Support record administration and review duties, including Certificates of Analysis and... 
    Weekly pay
    Temporary work
    Flexible hours

    Manpower Group Inc.

    Pomona, CA
    3 days ago
  •  ...medical/laboratory findings. Reviews informed consent forms for...  ...with SOP. Understands and utilizes donor center’s donor management...  ...specific regulations related to quality of product, employee and donor...  ...Nurse. Must have at least one (1) RN, LPN, LVN, EMT-P, or EMT-I... 
    Local area
    Immediate start
    Shift work
    Weekend work
    Afternoon shift

    Octapharma Plasma

    Azusa, CA
    3 days ago
  •  ...eligibility through medical history reviews, physical assessments, and...  ...center compliance with SOPs, quality systems, and regulatory...  ...It Takes Physician, LPN, or RN: Graduate of a recognized healthcare...  ...communication. Ability to utilize personal protective equipment... 
    Full time
    Temporary work
    Work at office
    Immediate start
    Flexible hours
    Shift work
    Weekend work
    Afternoon shift

    Octapharma Plasma

    Azusa, CA
    4 days ago
  •  ...year history of providing quality healthcare to the...  ...Registered Nurse (RN) licensure in the state...  ...of the most effective utilization of skills and abilities...  ...for meals and breaks. Reviews and takes action on requests...  ...with facility services to assure that the department and... 
    Full time
    Work experience placement
    Work at office
    Day shift

    Adventist Health

    Baldwin Park, CA
    1 day ago
  •  ...70-year history of providing quality healthcare to the community. We...  ...: Registered Nurse (RN) licensure in the state of practice...  ...appropriateness of resource utilization, consultations, treatment plan...  ...by conducting a focus study review of the previous and current... 
    Full time
    Work experience placement
    Work at office
    Day shift

    Adventist Health

    Baldwin Park, CA
    1 day ago
  •  ...Position Under the general direction of the Manager of Quality Assurance, the Quality Assurance Specialist is responsible for monitoring, evaluating, and...  ...services, ensuring timely, thorough, and objective review and resolution. Review and communicate quality assurance... 
    Hourly pay
    Work at office

    SAN GABRIEL POMONA VALLEYS DEVELOPMENTAL SERVICES INC

    Pomona, CA
    2 days ago
  • $52.99 - $80.97 per hour

     ...California, and hospital policies, goals, and objectives. Completes Utilization Review of Behavioral Health Services. Charge Nurse will have expert...  .... Minimum License Requirement: Current California RN License. BLS required Assaultive Behavior Training Certification... 
    Full time
    Shift work
    Night shift

    Emanate Health

    Covina, CA
    3 days ago
  • $55 - $60 per hour

     ...and has been offering quality and affordable health...  ...campus located Adjunct RN (Mental Health) Clinical...  ...Educational Nurse Specialist and others on content...  ...Leads in the conduct and utilization of nursing research....  ...care for them. Regularly reviews data that may reveal... 
    Hourly pay
    Full time
    Temporary work
    Part time
    Immediate start
    Shift work

    Success Education Colleges

    West Covina, CA
    2 days ago
  • $50 per hour

     ...dedicated team of professionals are committed to our core values of quality, compassion, and community! Why Prime Healthcare? Montclair...  ...perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of... 
    Daily paid
    Full time
    Part time
    Work experience placement
    Local area
    Shift work

    Prime Healthcare

    Montclair, CA
    5 days ago
  • $62.4k - $93.6k

    The Opportunity The Clinical Review Nurse - Prior Authorization is responsible for reviewing...  ...authorization activities within the Utilization Management (UM) department and supports delegated...  ...Who you are Active California LVN or RN license 3‑5+ years of current clinical... 

    Akido Labs

    Chino, CA
    3 days ago
  •  ...San Gabriel/Pomona Regional Center in Pomona, CA, is seeking a Quality Assurance Specialist to monitor, evaluate, and support vendor programs to ensure compliance with standards and regulatory requirements. The role provides technical assistance, conducts investigations... 

    SAN GABRIEL POMONA VALLEYS DEVELOPMENTAL SERVICES INC

    Pomona, CA
    3 days ago
  •  ...Registered Nurse is responsible for delivering safe patient care by utilizing the nursing process of assessment, planning, implementation, and...  ...diagnostic study results, and symptomatology. Additionally, the RN should be prepared to respond swiftly and accurately to changes... 
    Contract work
    Local area
    Night shift

    San Dimas Community Hospital

    San Dimas, CA
    4 days ago
  • $53 per hour

     ...professionals committed to our core values of quality, compassion and community! San Dimas...  ...responsible for the delivery of safe patient care utilizing the nursing process of assessment,...  ..., TRAINING # Current and valid state RN License.2. Current BLS certificate upon hire... 
    Daily paid
    Local area
    Shift work

    Prime Healthcare

    San Dimas, CA
    4 days ago
  • $43.25 - $61.16 per hour

     ...professionals committed to our core values of quality, compassion and community! San Dimas...  ...responsible for the delivery of safe patient care utilizing the nursing process of assessment,...  ..., TRAINING Current and valid state RN License. Current BLS certificate upon... 
    Full time
    Part time
    Local area
    Shift work
    Night shift

    Prime Healthcare

    San Dimas, CA
    2 days ago
  •  ...Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation, and...  .../ Certifications / Licensure Current and valid state RN License BLS Certification ACLS Certification Minimum of... 
    Contract work
    Local area

    San Dimas Community Hospital

    San Dimas, CA
    4 days ago
  • $43.25 - $59.37 per hour

     ...recognized nationally for its quality, including as among the 100 Great...  ...by Becker's Hospital Review in 2018 and as among the 100 Top...  ...delivery of safe patient care utilizing the nursing process of assessment...  ...1. Current and valid state RN License. 2. Current BLS certificate... 
    Full time
    Part time
    Local area
    Shift work

    Prime Healthcare

    Chino, CA
    5 days ago
  • $46 - $50 per hour

     ...dedicated and compassionate Registered Nurse (RN) to join our healthcare team. 8-hr...  ...will play a vital role in providing high-quality general/psychiatric nursing care to patients...  ...Demonstrates sound leadership skills and utilizes these skills in organizing the activities... 
    Daily paid
    All shifts
    Shift work
    Night shift
    Weekend work
    1 day per week

    Aurora Behavioral Charter Oak

    Covina, CA
    more than 2 months ago
  • $2,039.2 per month

     ...Travel Offering Nursing Profession RN Specialty ICU Job ID 37739345 Job Title...  ...Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation, and... 
    Weekly pay
    Contract work
    Local area
    Shift work

    Hackensack Meridian Health

    San Dimas, CA
    4 days ago
  • $43.25 - $59.37 per hour

     ...recognized nationally for its quality, including as among the 100 Great...  ...by Becker’s Hospital Review in 2018 and as among the 100 Top...  ...delivery of safe patient care utilizing the nursing process of assessment...  ...Qualifications Current and valid state RN License. Current BLS... 
    Full time
    Part time
    Local area
    Shift work
    Night shift

    Prime Healthcare

    Chino, CA
    3 days ago
  •  ...are dedicated to the highest quality of customer services delivered...  ...tight knit group and autonomy to utilize your knowledge and experience....  ...Department at Glendora. The RN will provide safe and therapeutic...  ...’ age specific needs. Assures implementation of patient care... 
    Shift work
    Night shift

    Glendora Hospital

    Glendora, CA
    24 days ago
  • $39.25 - $56.85 per hour

     ...serving the community with personalized, high‑quality care. We offer a full range of...  ...responsible for the delivery of safe patient care utilizing the nursing process of assessment,...  ...EXPERIENCE, TRAINING 1. Current and valid state RN license. 2. Current BLS certificate upon... 
    Full time
    Part time
    Local area
    Shift work
    Night shift

    Prime Healthcare

    San Dimas, CA
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to RN Utilization Review & Quality Assurance Specialist. Be the first to apply!