UM Nurse (RN): Care Coordination & Clinical Review Lead
Career Advocates
A healthcare organization in Los Angeles is looking for a candidate to support clinical operations by conducting complex clinical reviews. The selected individual will use clinical judgment and collaborate with stakeholders to ensure efficient care delivery. Key responsibilities include mentoring LVN staff and ensuring compliance with Medicare and Medi-Cal benchmarks. Applicants should have an accredited nursing degree and experience in healthcare or managed care settings. #J-18808-Ljbffr Career Advocates
- L.A. Care Health Plan is hiring a Managed Long Term Services and Supports Nurse Specialist RN II to coordinate interdisciplinary healthcare and social services for members. This full... ...degree, along with at least 3 years of clinical nursing experience. The position...SuggestedFull time
- ...bed hospital, wound care medical office and... ...with the Nurse Manager, Director,... ...Registered Nurse (RN) licensure in the... ...policy: Preferred Clinical specialty and/or nursing... .... Initiates and coordinates individual and... ...meals and breaks. Reviews and takes action on...SuggestedFull timeWork experience placementWork at officeDay shift
- ...hiring a full-time Registered Nurse (RN) to join our high-end... ...You will act as the central clinical lead for a small panel of patients... ...health quarterback” by managing care plans, triaging acute issues, and ensuring seamless coordination across providers. Our physician...SuggestedFull timePrivate practiceWork at officeShift workWeekend workAfternoon shift
- ...collaboratively with the Nurse Manager, Director,... ..., professional care that results in... ...Registered Nurse (RN) licensure in the... ...certification: Preferred Clinical specialty and/or... .... Initiates and coordinates individual and... ...meals and breaks. Reviews and takes action on...SuggestedFull timeWork experience placementNight shift
- A healthcare provider in Montebello, CA is looking for a Registered Nurse Supervisor (RN Supervisor) to join their team. The role involves providing high-quality care to residents, performing assessments, and administering medications. Ideal candidates are registered nurses...Suggested
$88.85k
...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management... ...(Max.) Established in 1997, L.A. Care Health Plan is an independent public... ...Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible...Full time$88.85k
...Clinical Policy Nurse RN II Job Category: Clinical Department: Utilization Management... ...) Established in 1997, L.A. Care Health Plan is an independent... ..., Utilization Management (UM) department and healthcare services policies. Reviews and analyzes clinical...Full timeLocal area$74.29k - $111.43k
...entitled to high‑quality, coordinated care. By uniquely aligning the interests... .... NeueHealth delivers clinical care to health consumers... ...The Concurrent Utilization Review (UR) Nurse is responsible for conducting... ...: Registered Nurse (RN) with an active, unrestricted...Work at office- ...over 2,000 sites of care and serving over... ...every year, nurses at Methodist Hospital... .... As an ICU Clinical Nurse Coordinator you can be a part... ...unparalleled. Leads in a way that inspires... ...Nurse (RN) required ~3 years... ...Acquisition team is reviewing applications for...Full timeTemporary workPart timeImmediate startFlexible hours
- A skilled nursing facility in California is seeking an RN Supervisor for the NOC Shift, both for full-time and part-time positions. The successful candidate will oversee nursing staff, coordinate care plans with residents and their families, and ensure quality care is...Full timePart timeNight shift
- Maywoodhc in Maywood, California is seeking a Charge Nurse (LVN or RN) to oversee a nursing unit and coordinate resident care. Responsibilities include supervising nursing staff, ensuring compliance with procedures, and maintaining documentation. Ideal candidates must...
- ...RN Clinical Staff Nurse - EmPATH - Full Time Nights $7 Differential The EmPATH... ...the management of patient care. Reporting to the EmPATH... ...organizing, planning, directing, coordinating, and providing high quality... ...patient outcomes. # Reviews all orders on patients and...Hourly payFull timeShift workNight shift
- ...overall operation of the nursing department in accordance... ..., med pass and wound care) Maintaining and updating... ...Working with MDS Coordinator in scheduling care plan meetings and reviewing resident records Reviewing... ...school or college Valid RN license in good standing...Local area
- Adventist Health in Glendale, California, seeks a nursing leader to coordinate daily unit activities and ensure quality patient care. The ideal candidate will hold a Bachelor's Degree in nursing with an RN licensure in California. Responsibilities include overseeing nursing...
- ...Management as an Inpatient UM Nurse Case Manager in Sherman Oaks... ...play a vital role in patient care coordination. Be part of a dynamic team dedicated... ...Requirements: Active RN license in California with a... ...preferred. Strong clinical assessment and critical thinking...Remote work
- ...Clinical Nurse Reviewer As one of the fastest growing Independent Physician Associations in Southern California, our organization offers a fast... ...1. Minimum of 2 years relevant work experience in a managed care setting, health plan or large medical group administration....Work experience placementFlexible hours
- ...We are seeking an Outpatient Nurse to join our team! You will be... ...Responsibilities: Administer nursing care both in and out of the... ...patients and their family members Coordinate staff breaks Ensure... ...Description Multi-Specialty Clinic Company Description Multi...Daily paid
$2,400 - $2,600 per week
...Registered Nurse (RN) | Case Manager Location: Santa Monica, CA Agency: United Health Care Staffing, Inc. Pay: $2,400 to $2,600 per week... ...Manager will be responsible for coordinating patient care, performing admission reviews, and managing discharge planning...Full timeContract workImmediate startShift workWeekend workDay shift- ...Registered Nurse (RN) | Case Manager Location: Santa Monica, CA Agency: United Health Care Staffing, Inc. Pay: Competitive weekly pay (inquire for... ...Manager experience performing Care Coordination and Admission Reviews, must be current experience within the...Weekly payFull timeContract workImmediate startShift work
$2,600 - $2,850 per week
...Registered Nurse (RN) | Case Manager Location: Santa... ...: United Health Care Staffing, Inc. Pay... ...management and utilization review to ensure patients... ...utilization decisions Coordinate care across the... ...that values you and your clinical judgment Licensure...Full timeContract workLocal areaImmediate startMonday to FridayShift workWeekend workDay shift$3,073 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab... ...delivers specialized nursing care to patients undergoing... ...assessments, including review of medical history and... ...proper placement of ECG leads and monitoring equipment... ...and families to ensure coordinated care Follow all safety...Full timeContract workImmediate startShift work- A health care organization in Los Angeles is seeking a Registered Nurse/Clinical Supervisor to provide health care interventions, supervise back office staff, and implement... ...for bilingual individuals. This role involves coordinating patient care and ensuring high standards of...
- ...Job Description Job Description Clinical Research Registered Nurse (RN) Infusion Job Type : Full Time... ...This role combines direct patient care with clinical research responsibilities... ...work closely with investigators, coordinators, and sponsors to ensure compliance...Full timeMonday to FridayShift work
- CommonSpirit Health in Glendale, California is seeking an Educator to coordinate and deliver healthcare-related educational programs. This... ...candidate will possess three years of experience in critical care nursing, be a current Registered Nurse in California, and have a...
- ...Therapy Registered Nurse, as qualified by... ...quality care to all patients and... ...a holiday. We lead the industry in clinical quality improvement... ...Communicate and regularly review Emergency... ...Hemodialysis Only: Coordinate home evaluation... ...include: ~ Current RN license in...Full timePart timeLocal areaMonday to FridayFlexible hoursNight shiftWeekend work
- ...Job Description Job Description: Clinical Supervisor, UM Denial Compliance Location: Los Angeles... ..., managing daily tasks, performance reviews, and disciplinary actions. 2.... ...from an accredited Registered Nursing Program; RN preferred. 2. Minimum of five years...Permanent employmentTemporary workRemote work
- This role supports clinical operations by conducting complex clinical reviews and coordinating care to ensure medical necessity and benefit compliance. The selected candidate... ...Qualifications Graduate of an accredited nursing program (ASN, ADN, BSN, or MSN). Bachelors preferred...
- Working Nurse is seeking a Utilization Management Claims Review Nurse RN II in Los Angeles. This full-time position involves clinical review of medical claims to ensure services are warranted and... ...Medi-Cal and Medicare in managed care. Join us to make a difference in the...Full time
$88.85k
...Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals... ...Established in 1997, L.A. Care Health Plan is an independent... ...care access or benefit coordination issues, ensuring that... ...), DMHC, and external review organization (QIO or IRE...Full timeRemote workShift workWeekend work- ...MedPOINT Management as a Medical Claims Clinical Review Nurse in Sherman Oaks, CA, where you'll play a... .... Requirements: Registered Nurse (RN) license in California is required. Minimum... ...to excellence and patient-centered care has earned us the trust of our clients...Remote work
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