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
$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-...SuggestedFull time- 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
$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...SuggestedFull time$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....SuggestedFull timeLocal area- 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
- 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...
- 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...
$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$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 timeFor contractorsLocal area- ...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 payTemporary workFlexible hours
- ...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 areaImmediate startShift workWeekend workAfternoon shift
- ...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 timeTemporary workWork at officeImmediate startFlexible hoursShift workWeekend workAfternoon shift
- ...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 timeWork experience placementWork at officeDay shift
- ...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 timeWork experience placementWork at officeDay shift
- ...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 payWork at office
$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 timeShift workNight shift$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 payFull timeTemporary workPart timeImmediate startShift work$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 paidFull timePart timeWork experience placementLocal areaShift work$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...- ...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...
- ...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 workLocal areaNight shift
$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 paidLocal areaShift work$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 timePart timeLocal areaShift workNight shift- ...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 workLocal area
$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 timePart timeLocal areaShift work$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 paidAll shiftsShift workNight shiftWeekend work1 day per week$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 payContract workLocal areaShift work$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 timePart timeLocal areaShift workNight shift- ...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 workNight shift
$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 timePart timeLocal areaShift workNight shift
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