Utilization Management Review Nurse
Astrana Health
Utilization Review Nurse
Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans. This is a remote position for CA-licensed nurses. Candidates must live in California.
We are seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting.
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
$34 - $47 per hour
...Description Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position... ...seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting. Our Values:...SuggestedHourly payLive inWork at officeRemote workMonday to FridayShift work$30 - $34 per hour
A health services company is seeking a Utilization Management Review Nurse in Monterey Park, CA. This hybrid role includes conducting reviews for inpatient admissions and outpatient procedures, ensuring compliance with regulations, and working collaboratively with the team...SuggestedHourly payWeekend work$88.85k
...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13266 Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $14...SuggestedFull time$65.8k - $130.8k
...0 Primary Duties and Responsibilities The UM Denial Nurse Reviewer supports high-quality, cost-effective care by applying... ...CA LVN licensure required Two or more years of utilization review/utilization management experience in an HMO, MSO, IPA, or health plan environment...SuggestedRemote workMonday to FridayFlexible hours$34 - $47 per hour
Astrana Health Management in California is seeking a CA-licensed Utilization Review Nurse to support our Health Services Department. You will review outpatient services for medical necessity according to plan criteria. This is a remote role for CA-licensed nurses; candidates...SuggestedRemote jobHourly pay- UCLA Health in Los Angeles hires a Denial Nurse Reviewer to support high-quality, cost-effective care by applying clinical knowledge, policies, and regulatory guidelines to review and process adverse organization determinations. Responsibilities include reviewing denials...Remote job
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$30 - $34 per hour
...Dr., Monterey Park, CA 91754 Compensation: $30.00 - $34.00 / hour Department: Health Services (HS - UM) Job Title Utilization Management Review Nurse About the Role Astrana Health is looking for a Utilization Review Nurse to assist our Health Services Department. This...Hourly payWork at officeMonday to FridayShift work- ...QUALIFICATIONS REQUIRED: Must be a graduate from a reputable nursing school. Should hold a valid and current RN license.... ...timely receipt of medications ordered within the last 24 hours. Manage IV and central line procedures. Verify sign-in sheets in alignment...Night shift
- ...Job Description Job Description We’re a skilled nursing facility and we are looking for dynamic associates to join our clinical team... ...or a nurse aide trainee qualified to perform the procedure. Review nurses’ notes to ensure that they are informative and...Full timePart timeTraineeshipNight shift
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...Program Director- Vocational Nursing ProgramSalary: $$ 140000 - $$ 150000 per yearLocation: Alhambra, CaliforniaMinimum Degree:Relocation... ...success. This role requires an innovative leader who can manage the program's strategic direction while ensuring compliance with...Relocation package- ...Community Hospital in South Los Angeles is seeking an RN Care Manager to coordinate inpatient care for a diverse, high-acuity population... ...role, you will use clinical judgment and EHR tools to manage utilization, reduce readmissions, support families, and advance equity,...
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...Join to apply for the Case Manager (LVN or RN) role at Astrana Health... ...95 - 100% compliance with Utilization Management health plan delegation... ...initial and concurrent reviews based on the review of medical... ...Qualifications Active Registered Nurse (RN) license in California OR...Hourly payFull timeWork at office- ...across all locations; supervise, train, and conduct performance reviews for Medical Coordinators and Assistants. Clinical Oversight:... ..., including health screenings, triage, and emergency response. Manage medication administration and tracking (MARs). Compliance &...Work at office
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