RN Utilization Management: Drive Efficient Patient Care
$67.5 - $75 per hourVetJobs
VetJobs is seeking a Utilization Review Case Manager in Los Angeles, CA to assess medical necessity and care levels using InterQual, MCG, and CMS Two‑Midnight Rule. You will collaborate with physicians, care coordinators, and payers to secure timely authorizations and optimize hospital resources. The ideal candidate has an RN license, 3 years of acute nursing, and 2 years in case management; BLS and CPT coding experience are preferred. Salary range is $67.50–$75.00 per hour. #J-18808-Ljbffr VetJobs
- 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 and...SuggestedRelocation package
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work... ...The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents... ...of 8 hours per day, requiring an RN with a Bachelor's degree, state...SuggestedRemote jobWork from homeMonday to Friday
$88.85k
...Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization... ...in 1997, L.A. Care Health Plan is an independent... ...facilitation/coordination of patient transfers between acute... ...processes and increase efficiencies. Takes the initiative to...SuggestedFull timeNight shift- PIH Health Downey Hospital in Downey, CA is seeking an RN Case Manager to coordinate care from pre-admission through post-discharge, ensuring efficient patient flow and appropriate utilization of hospital services. The role focuses on discharge planning, educating staff...Suggested
- ...an experienced nurse case manager to assess and coordinate care for diverse patients. You will collaborate with... ...include risk stratification, utilization review, discharge planning, and driving performance improvement... ...will have BSN or MSN, CA RN license, BLS, and 3+ years...Suggested
- ...RN - Utilization Management ID 2026-25367 Category Registered Nurse specialties - Case Manager Facility... ...s home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health care costs for the dependents of...Full timeContract workWork at officeRemote workWork from homeMonday to Friday
- ...Outpatient Case Management West Los Angeles VAMC... ...are five new RN vacancies at the West... ...We are seeking a Utilization Management Nurse to... ...responsible for reviewing patient files and... ...methods with an eye for efficiency and effectiveness.... ...under our care are receiving the...For contractorsWork at officeImmediate startRelocation packageMonday to FridayFlexible hours
$64.74 - $79.23 per hour
...alternate levels of care when the patient does not meet the medical... ...patient advocate and manages patients in the most... ...delivered timely and efficiently. Participates in the... ...of care, including Utilization management, Transfer... ...Two (2) years combined RN experience in an...Full timeWork experience placementLocal areaShift workWeekend work- ...Utilization Review Case Manager The Utilization Review Case Manager is responsible for assessing the medical necessity, appropriateness, and efficiency of patient care services. Utilizing evidence-based clinical criteria such as InterQual, MCG, and the CMS Two-Midnight...Night shift
- ...Nurse Director of Case Management Utilization Review —ignite an impact-driven leadership... ...Review will champion care coordination excellence, operational efficiency, and patient-centered outcomes in a thriving... ...and evidence-based tools to drive utilization management, while...Full timeRelocation packageWeekend work
- Job Description The Utilization Review Case Manager is responsible for assessing the medical necessity, appropriateness, and efficiency of patient care services. Utilizing evidence-based clinical criteria... ...Licenses and Certifications RN State License - minimum Basic...Night shift
- ...: Outpatient Case Management West Los Angeles VAMC... ...are five new RN vacancies at the West... ...We are seeking a Utilization Management Nurse to... ...for reviewing patient files and treatment... ...methods with an eye for efficiency and effectiveness.... ...under our care are receiving the...Work at officeRelocation packageFlexible hours
- L.A. Care Health Plan in Los Angeles, CA seeks an Utilization Management Nurse Specialist RN II to coordinate and approve referrals that meet criteria. You will monitor inpatient... ...with on-site staff to discharge patients effectively. Ideal candidate has 5+ years RN...
$31.93 per hour
...demonstrate our belief that quality care is for everyone. Our... ...just a job; it's a calling that drives us forward every day. Job Overview The LVN Utilization Management Nurse (UM Nurse) will provide... ...for medical necessity and efficiency with coverage guidelines. The...Hourly payFlexible hours$102.18k
RN Job Supervisor, Utilization Management RN Shift: Full Time Pay Range: $102,183.00 (Min.) - $132,838.00 (Mid.... ...UM department, and monitoring the Care Management (CM) staff’s responsibilities... ...operations to ensure optimal efficiency, productivity, and effectiveness; documenting...Full timeShift work$125k - $135k
...with a Hospice & Palliative care innovator! Be part of a... ...we prioritize not only our patients and families but also our valued... ...a Hospice Patient Care Manager / Clinical Manager (RN) in the Los Angeles area who... ...driver’s license and a good driving record as a condition of employment...Full timeFlexible hours$88.85k
RN Job Utilization Management Admissions Liaison RN II (Nights) Shift Full Time Nights Pay Range $88,854... ...admission requests and higher level of care (HLOC) transfer requests from... ...team for facilitation/coordination of patient transfers between acute care facilities...Full timeShift workNight shift- L.A. Care Health Plan in Los Angeles is seeking a Utilization Management Admissions Liaison RN II responsible for overseeing inpatient admission requests and transfers. Candidates... ...timely and accurate determinations for patient care, with a focus on collaboration across...
- ...Inpatient Case Manager The Inpatient Case Manager... ...on identified patients during an acute care episode. Assesses and... ...severity of illness, utilizing the appropriate tests... ...care, in the most efficient manner, while utilizing... .... May need to drive to South Bay area on...Permanent employmentFlexible hours
$88.85k
...Clinical Policy Nurse RN II Job... ...Clinical Department: Utilization Management Location: Los... ...in 1997, L.A. Care Health Plan is an... ...designed to improve patient outcomes, detect... ...at improving efficiency and compliance identified... ...stakeholders to drive evidence-based...Full timeLocal area$47.31 - $100 per hour
...RN Case Manager In collaboration with the interdisciplinary... ...team, provides care coordination... ...of specific patient populations. The... ...the functions of utilization management, quality... ...effective and efficient plan of care. Identifies... ...delays in the M drive. Maintains...Hourly payDaily paidContract workWork experience placementLocal area$47.58 - $76.68 per hour
...Utilization Review Nurse Responsible for admissions, concurrent and... ...retrospective reviews of all patients in accordance with the criteria... ...in Utilization/Quality/Case Management in acute setting preferred... ...-year legacy of personalized care from expert physicians, experienced...Hourly payDaily paidWork experience placementLocal areaDay shift- ...Case Manager - RN Per Diem Day Shift Under... ...clinical resource utilization and documentation... ...physicians in resource efficiencies and documentation... ...of all patients, assessing the medical... ...members of the health care team in removing... ...the GMLOS to drive length of stay....Daily paidShift workDay shift
- ...support the Chief Nursing Officer in leading a patient care team, ensuring safety, recovery and... ...supervising staff, educating patients, and driving quality improvements in a fast-paced... ...setting. Current role requires California RN license, BSN preferred, and 1 year acute...
$98.52 per hour
Job Details RN Job RN Case Manager, Per Diem (rotating weekends... ...and coordinating care for a diverse group of patients. You will... ...individualized care plans utilizing evidence-based... ...safe, high quality, efficient, and cost-effective... ...to you to help drive performance improvement...Daily paidShift workDay shift$65.53 - $84.75 per hour
# RN Case Manager - Complex CasesWork Location **Santa... ...to transform the patient experience. When... ...leading-edge care as you build an exceptional... ...care plans utilizing evidence-based... ...safe, high quality, efficient, and cost-... ...looking to you to help drive performance...Hourly payMonday to Friday$68.81 - $88.99 per hour
...and coordinating care for a diverse group of patients. You will... ...individualized care plans utilizing evidence-based... ..., high quality, efficient, and cost-... ...to you to help drive performance improvement... ...staff) CA RN License and BLS... ...experience in case management, utilization management...Hourly payRemote workDay shift- ...Outpatient Clinics in Los Angeles seeks an RN Supervisor (Ambulatory Care Patient Supervisor II) to oversee clinical management and administrative coordination of the Westwood... ...administrative leadership to ensure safe, efficient, high-quality patient-centered care and #J...
$95.35k - $119.19k
...our belief that quality care is for everyone. Our... ...; it's a calling that drives us forward every day.... ...Job Overview The RN Case Manager provides daily care coordination... ..., and intervention to patients with one or more... .../clinic referral, utilization management referral, disease...Flexible hours$50 - $55 per hour
...SCAN Care Coordinator Founded in 1977 as... ...business hours - CA RN Required The Job... ...to age in place, manage their health, navigate... ...Hospital Or ED Utilization, Adults Living In The... ...member engagement and patient activation to... ...responsibility to drive Equality in our communities...Hourly payTemporary workLocal areaRemote work
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