Utilization Review RN | Impactful Care & Payer Collab
Incredible Health
Incredible Health is seeking a Registered Nurse - Utilization Review in Los Angeles, CA. This role is ideal for nurses with experience in Clinical pathway, Navigator, or Utilization Review. The position offers full time and part time options, along with comprehensive benefits including medical, dental, vision, 401K, and paid time off. Candidates must hold an RN Diploma and an active nurse license in California. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Utilization Review RN | Impactful Care & Payer Collab in Los Angeles, CA vacancy
$74.29k - $111.43k
...to high‑quality, coordinated care. By uniquely aligning the interests... .... Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for... ...communication with payers, and ensuring compliance with... ...Education: Registered Nurse (RN) with an active, unrestricted...SuggestedWork at officeNeueHealth
Los Angeles, CA4 days ago$2,065 - $2,160 per week
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Los Angeles, CA26 days ago- ...Neuehealth is seeking a Concurrent Utilization Review Nurse in Los Angeles, CA. This vital role... ...necessity of healthcare services under managed care health plans. Responsibility includes... ..., facilitating communication with payers, and adhering to compliance guidelines....Suggested
NeueHealth
Los Angeles, CA2 days ago - ...Monterey Park is seeking a Case Manager RN or LVN to join our Utilization Review Department. This per diem position involves coordinating care for patients, conducting admissions, and... ...solving skills. Join us to make a meaningful impact in patient care. #J-18808-Ljbffr...SuggestedDaily paid
Air Combat Effectiveness Consulting Group LLC
Monterey Park, CA2 days ago $71k - $151k
...Incredible Health is seeking Registered Nurses for Utilization Review roles in Los Angeles, CA. Candidates should possess an RN Diploma or higher and an active license in California. The job offers both full-time and part-time positions. In addition to competitive salaries...SuggestedFull timePart timeDay shiftIncredible Health
Los Angeles, CA14 hours ago$1,900 - $2,500 per week
...Job Title: Travel RN Case Management Utilization Review Location: Carmichael, CA Salary Range: From $1,900 to $2,500 per week Shift: 8-hour... ...crucial for ensuring that patients receive appropriate care while managing healthcare resources effectively. Key...Weekly payContract workRelocationMonday to FridayShift workDay shiftforhyre.com
Los Angeles, CA2 days ago- ...L.A. Care Health Plan in Los Angeles is hiring a Utilization Management Claims Review Nurse RN II responsible for conducting clinical reviews of medical claims. The position requires a minimum of 5 years in clinical nursing, with experience in Medi-Cal and Medicare managed...
L.A. Care Health Plan
Los Angeles, CA5 days ago $88.85k
...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 900... ...Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by...Full timeL.A. Care Health Plan
Los Angeles, CA3 days ago- ...Registered Nurse (RN) | Utilization Review Location: Los Angeles, CA Agency: GQR Healthcare Pay: Competitive weekly pay (inquire for details) Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About...Hourly payWeekly payFull timeContract workImmediate startShift work
GQR Healthcare
Los Angeles, CA3 days ago - ...POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support... ...UM process. It coordinates care submission relating to the... ...hospital stays, and discharge review that determines medical necessity... ...clinical information to payer as needed. Collaborates with...Full time
Martin Luther King Jr. Community Hospital
Huntington Park, CA2 days ago $41.38 - $69.02 per hour
...7-10 Position Title: RN Utilization Management Nurse (InPatient)... ...California HMO is responsible for review of the most complex or... ...appropriate type, level, or quality of care, e.g., if services are not in... ...passionate about making an impact on our members and the...Full timeTemporary workWork experience placementWork at officeLocal areaShift work1 day per weekElevance Health
Los Angeles, CA2 days ago$112.9k - $256.9k
...Description Take on a high-impact role within a world-... ...of exceptional patient care. Take your career to... ...for Medicare Advantage Utilization Management, you’ll provide... ...Letters Concurrent Review Continuity of Care Retro... ...: Current unrestricted RN licensure in CA required...Direct Jobs
Los Angeles, CA1 day ago- ...day has a crucial impact on the lives of others... ...level of care based on nationally... ...and continued stay reviews in determining appropriate... ...communication with payers as required Follow... ...as defined in the Utilization Review Plan in accordance... ...California RN license required...Daily paidSeasonal work
$30.37 - $59.21 per hour
Molina Healthcare in Los Angeles seeks a Clinical Review Nurse to support clinical member services. Responsibilities include assessing... ...will have at least 2 years of experience in hospital acute care and an active RN license. This position offers a competitive hourly pay range...Hourly pay$30.37 - $59.21 per hour
...and compliant with guidelines. Key responsibilities include analyzing requests, conducting reviews, and collaborating with multidisciplinary teams. Applicants must have an active RN license and at least 2 years of relevant experience. The position offers a competitive...Hourly pay$74.16 - $107.75 per hour
Description The Utilization Review Nurse is part of the Utilization Management Department at the Resnick Neuropsychiatric... ...BSN or MSN, required 5 years of psychiatric nursing care experience required. Current valid CA RN license, required BLS from the ARC or AHA,...Work at office$47.2 - $63.45 per hour
...for high quality and compassionate medical care. St. Francis is recognized for its full... ...and comprehensive admission and concurrent review of the medical record for the medical necessity... ...Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years...Full timePart timeWork experience placementLocal areaShift workSt. Francis Medical Center
Lynwood, CA4 days ago$26.35 - $39.53 per hour
...Neuehealth is seeking a Concurrent Utilization Review Nurse in Los Angeles, California. The role involves conducting real-time clinical reviews... ...healthcare providers and facilitating communication with payers. Ideal candidates will have clinical experience and familiarity...Hourly payNeueHealth
Los Angeles, CA4 days ago$74.16 - $107.75 per hour
The University of California - Los Angeles Health is seeking a Utilization Review Nurse to support its Utilization Management Department. This... ...compliance. Candidates must have a BSN or MSN, a valid California RN license, and five years of psychiatric nursing experience. The...Hourly pay- ...An established industry player in healthcare is seeking a dedicated Utilization Management Nurse to enhance patient care efficiency. In this vital role, you will review patient files and treatment methods, ensuring that every patient receives the necessary treatments...Relocation package
Presidential Staffing Solutions, LLC
Los Angeles, CA4 days ago - ...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... ...and knowledge of Medi-Cal and Medicare in managed care. Join us to make a difference in the community with a...Full time
Working Nurse
Los Angeles, CA4 days ago $99.31k - $131.09k
...WelbeHealth is transforming the reality of senior care by providing an all‑inclusive healthcare... ...designated UM team Assist the team in reviewing prior‑authorization requests for medical... ...staff, and others to timely resolve any utilization management issues Job Requirements...WelbeHealth
Los Angeles, CA4 days ago- ...Manages the day-to-day operations of the Utilization Management Program in the Service Area or... ...Ensures cost effective and quality patient care by appropriate utilization of resources.... ...direction to staff regarding utilization review, care coordination, discharge planning,...Local area
MDA Edge
Los Angeles, CA4 days ago - ...Direct Jobs is seeking a Utilization Management Nurse in Los Angeles, CA, to support level-of-care determination and optimize patient... ...Nurse will conduct utilization reviews, ensure timely access to care,... ...psychiatric nursing, and a current CA RN license. The role includes...
Direct Jobs
Los Angeles, CA4 days ago $71k - $151k
...Registered Nurse - Utilization Review Hospitals on Incredible Health are actively hiring and accepting applications in the Los Angeles, CA... ...EAP, FSA, Medical, PTO, Retirement Plan Qualifications RN Diploma degree or higher from an accredited school of nursing...Full timePart timeShift workDay shiftColorwave Inc
Los Angeles, CA4 days ago$71k - $151k
...Registered Nurse - Utilization Review Hospitals on Incredible Health are hiring and accepting applications in the Los Angeles, CA area. Work Details... ...Job types available: full time and part time Qualifications RN Diploma degree or higher from an accredited school of nursing...Full timePart timeShift workDay shiftIncredible Health
Los Angeles, CA3 days ago$99.31k - $131.09k
...Utilization Management RN At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to the most vulnerable senior population... ...designated UM team Assist the team in reviewing prior-authorization requests for medical...WelbeHealth
Los Angeles, CA3 days ago$53.08 - $79.85 per hour
...this role, you will provide direct nursing care, assess and evaluate patients, and work... .... Candidates must hold a valid California RN license and have experience in Telemetry and... ...hourly, with opportunities to make a significant impact on patient care. #J-18808-Ljbffr...Hourly payFull timeNight shiftPIH Health
Downey, CA4 days ago- ...Astrana Health Management is seeking a CA-licensed UM Review Nurse to review outpatient medical services. Candidates should have 1+ years of outpatient Utilization Management experience, work remotely, and maintain availability for shifts 8 AM – 8 PM PST, Monday through...Remote workShift work
Astrana Health Management
Monterey Park, CA4 days ago $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...Hourly payWeekend workAstrana Health
Monterey Park, CA5 days ago
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