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
$88.85k
...Established in 1997, L.A. Care Health Plan is an... ...Management Nurse Specialist RN II facilitates, coordinates, and approves medically... ...and concurrent review, and collaborates with... ...plan. Works with the UM Manager and... ...years of varied RN clinical experience in an acute...Suggested- ...Lead Case Manager Join Our... ...highest quality of care throughout... ...and Skilled Nursing Facilities. We... ...needs, coordinating care, and ensuring... ...hospitalists to review patient care... ...to manage clinical information and... ...care. An RN or LVN license... ...experience (UM or DC Planning...SuggestedSeasonal workShift work
$88.85k
...Utilization Management Clinical Quality Nurse Reviewer RN II Salary Range: $88,854.00... ...$142,166.00 (Max.) L.A. Care Health Plan is an independent... ...Utilization Management (UM) Department Leadership Team... ...external audits as well as leads pre- and post-audit preparation...Suggested- ...bed hospital, wound care medical office and... ...with the Nurse Manager, Director,... ...Registered Nurse (RN) licensure in the... ...certification: Preferred Clinical specialty and/or... .... Initiates and coordinates individual and team... ...meals and breaks. Reviews and takes action...SuggestedFull timeWork experience placementWork at officeDay 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
- ...bed hospital, wound care office, and... ...collaboratively with the Nurse Manager, Director,... ...Registered Nurse (RN) licensure in the... ...: Preferred Clinical specialty and/or nursing... ..., initiates and coordinates individual and team... ...meals and breaks. Reviews and acts on requests...Part timeWork at officeDay shift
- ...bed hospital, wound care medical office and... ...with the Nurse Manager, Director,... ...Registered Nurse (RN) licensure in the... ...certification: Preferred Clinical specialty and/or nursing... .... Initiates and coordinates individual and... ...and breaks. Reviews and takes action on...Full timeWork experience placementWork at officeNight shift
- ...bring your expert clinical skills to a world-... ...Magnet designation for nursing excellence. From... ...level of care based on nationally... ...and continued stay reviews in determining appropriate... ...with Care Coordinators to identify and follow... ...of an accredited RN nursing program required...Shift work
- 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...
- A healthcare organization in Montebello, California, seeks a Registered Nurse to deliver coordinated nursing care and supervise nursing staff. The ideal candidate will have a Bachelor's Degree in Nursing and preferably experience in an acute care facility. Responsibilities...
$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$86.36k - $108.43k
...Hospital is a 362-bed acute-care hospital with a 24-hour... ...is a Registered Nurse who assumes 24-hour administrative... ...of receiving and reviewing referrals for... ...administration to ensure coordination of care and effective utilization... ...9499 CategoryManager RN Position TypeFull...Daily paidFull timeTemporary workPart timeLocal areaShift work$75k
...Licensed Vocational Nursing Lead REPORTS TO: Director of Recuperative Care LOCATION: Arleta,... ...oversight of all day-to-day clinical and administrative... ...and manage LVN/Medical Coordinator staff to ensure... ...meetings, daily board review, and all required staff...Work experience placementFlexible hoursShift work- 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
- ...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
$49 per hour
...passionate about delivering care as we are to come... .... Our Senior RN-Case Managers... ...with state-specific nurse practice act, and regulatory... ...Participate, coordinate and manage client care... ...as a local on-site clinical resource as needed... ...validation Review and evaluate clinical...Hourly payLocal areaFlexible hoursShift work$83.25k - $136.22k
...Position Title: RN Nurse Case Manager ll (... ...for performing care management within... ...developing, implementing, coordinating, monitoring, and... ...of 5 years of clinical experience; or any... ...strategy but will also lead to personal and... ...law should review the education and...Full timeTemporary workWork experience placementWork at officeLocal areaShift work1 day per week- ...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
- 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...
- ...Angeles is seeking a full-time Registered Nurse to provide high-quality patient care. The role involves planning, directing, and coordinating individualized care while monitoring... ...Qualified candidates must have a California RN license and experience in an acute care setting...Full timeDay shift
- ...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
- ...overall operation of the nursing department in accordance... ..., med pass and wound care) Maintaining and updating... ...department Working with MDS Coordinator in scheduling care plan meetings and reviewing resident records... ...school or college Valid RN license in good standing...Local areaImmediate startRelocation package
- 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...
$34 - $47 per hour
...UM Review Nurse - LVN Department: HS - UM Employment Type: Full Time Location: 1600... ...In this position, you will utilize your clinical judgement to approve or deny outpatient... ...Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence...Hourly payFull timeLive inWork at officeRemote workMonday to FridayShift work- ...Medicare/MDS Coordinator Under the direction and supervision... ...of the Director of Nursing Services, the Medicare/... ...licensure in nursing. RN required. • Written... ...experience in long term care preferred. • Supervisory... ...and Responsibilities: Clinical • Coordinates the...
- 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
- Cedars-Sinai in Los Angeles is seeking a utilization review nurse. The role involves validating patient placements, utilizing medical necessity... ...Qualifications include an associate degree in nursing, current RN state license, and relevant experience. Preferred candidates...Shift 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...
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