RN Utilization Management Specialist
Martin Luther King Jr. Community Hospital
Martin Luther King, Jr. Community Hospital is seeking an RN Utilization Management to act as a support liaison across various UM functions. This role ensures patient care efficiency from admission to discharge, including management of the clinical denials process. The ideal candidate will have at least 3–5 years of experience in Case Management or Utilization Management and a current California RN License. Bilingual skills preferred, and the position requires strong organizational abilities and effective communication with interdisciplinary teams to optimize patient outcomes. #J-18808-Ljbffr
- ...Martin Luther King, Jr. Community Hospital is seeking a Registered Nurse for the Utilization Management team. The RN UM coordinates care submissions and manages clinical denials while ensuring high-quality patient care. Ideal candidates will have 3-5 years of Case Management...Suggested
- ...Martin Luther King, Jr. Community Hospital is looking for a dedicated RN Utilization Management nurse to manage healthcare utilization from admission to discharge. You will coordinate care documentation and work closely with the insurance team to ensure high-quality care...Suggested
- ...Martin Luther King, Jr. Community Hospital is seeking a skilled RN Utilization Management professional to function as a support liaison for various UM functions. The role involves coordinating care from admission to discharge, managing clinical denials, and ensuring adherence...Suggested
- ...Martin Luther King, Jr. Community Hospital is seeking a dedicated RN for the Utilization Management team. The RN UM will act as a liaison for various utilization management functions, coordinating care submissions throughout the healthcare process. The ideal candidate...Suggested
$52.25 - $80.99 per hour
MLK Community Healthcare is looking for an RN Utilization Management to oversee the coordination of care submissions and manage clinical denials. The role requires an Associate's Degree in Nursing, with preference for a BSN, and a California Registered Nurse License. Responsibilities...SuggestedHourly pay$55.56 - $85.96 per hour
...A healthcare facility in California is seeking a Utilization Review Case Manager to validate patient admissions and levels of care. The role involves performing patient chart reviews, securing authorizations for clinical services, and collaborating with healthcare teams...Hourly pay$25.13 - $37.96 per hour
Torrance Memorial Medical Center is hiring a Utilization Review Assistant to ensure utilization management documentation and information requirements are met. The role includes coordination between various departments and managing payer communications. The ideal candidate...Hourly pay- Providence Health & Services is seeking a Clinical Program Manager RN for full-time evening shifts at Providence Little Company of Mary... ...hold a nursing degree and possess relevant experience in Utilization Management. Join us to be part of a supportive environment that...Remote jobFull timeAfternoon shift
$41.38 - $69.02 per hour
...Anticipated End Date: 2026-07-10 Position Title: RN Utilization Management Nurse (InPatient) - California HMO Job Description: RN Utilization Management Nurse (InPatient) - California HMO Virtual: This role enables associates to work virtually full...Full timeTemporary workWork experience placementWork at officeLocal areaShift work1 day per week$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, functioning as both a care provider and care plan to those individuals we serve. Our...- ...Description Job Summary Provides support for critical incident management activities, including provision of critical incident management... ...of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice....Remote jobLive inWork at office
- ...assigned panel of physicians to manage the patients specialized... ...alternative levels of care and utilization of resources, promotes self-care... ...Primary Care Physicians, Specialists and various disciplines on the... ...years clinical experience as an RN in an acute care or...Daily paidContract workWork at officeLocal area
- ...Utilization Specialist Kheir's mission is to increase and provide access to culturally and linguistically-sensitive quality primary healthcare... ...healthcare providers to optimize patient outcomes while managing costs. The Utilization Specialist will work closely with...Local area
$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 Salary Range: $88,854.00 (Min.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is...Full time- A senior living community in Torrance, California, is hiring a Kitchen Utility Associate (Dishwasher). This role is essential for maintaining cleanliness in the kitchen by washing and sanitizing dishes and equipment. Suitable candidates should have strong attention to detail...Flexible hoursShift workWeekend work
$116.3k - $264.6k
...UCLA Outpatient Clinics is looking for an experienced Utilization Management Assistant Director in Los Angeles. In this key leadership role, you will oversee Intensive Case Management and Utilization Management operations, ensuring high-quality patient care across complex...- The RN Utilization Management (RN UM) functions as a support liaison for a variety of UM functions which may include the e‑TAR process, denials management, and the UM process. Coordinates care submission relating to the process of health care utilization from the point...Full timeLocal area
- 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...
$112.9k - $256.9k
...exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you’ll provide direct management to a team of UM coordinators and nurses. You’ll work closely with Medicare...- Ocean State Job Lot is seeking an RN for Utilization Management in Los Angeles, CA. This role involves coordinating care submissions and documentation for patient admissions, focusing on high-quality care and efficiency. Candidates must hold an Associate's Degree in Nursing...
- MedPOINT Management is hiring a UM Outpatient Licensed Clinician in Los Angeles, California. In this role, you... ...and continuity of services. A current California RN or LVN license and 2+ years of experience in utilization management are required. Proficiency in Microsoft...Work at office
$116.3k - $264.6k
UCLA Health is seeking a leader for Intensive Case Management and Utilization Management programs in Los Angeles. This role involves supervising a... ...transitions. The ideal candidate will have a Bachelor's in Nursing, RN licensure in California, and several years of experience in...- L.A. Care Health Plan is seeking a Supervisor of Utilization Management RN to lead the daily operations of the UM department in Los Angeles. This role requires extensive clinical experience and supervisory skills to ensure department efficiency and quality care delivery...Full time
$35 - $45 per hour
Cordoba Corporation is seeking a Project Support III based in Los Angeles. This role involves managing document control and project support functions for engineering initiatives in the gas sector. Ideal candidates will have over 7 years of experience in similar roles,...Hourly payWork at office$116.3k - $264.6k
...centered care. UCLA Health is seeking a dynamic and experienced Utilization Management Assistant Director to oversee Intensive Case Management (ICM)... ...Qualifications All items are required: Current unrestricted RN licensure in CA required Bachelor of Science, Nursing (BSN)...Work at office- The University of California - Los Angeles Health is looking for a dynamic Utilization Management Assistant Director to supervise Intensive Case Management and Utilization Management operations. This role involves leading a multidisciplinary team to improve patient outcomes...
- ...Metadata Specialist I Job Summary Getty seeks a forward-thinking Metadata Specialist to join... ...into a centralized digital asset management system and data management platform. This... ...migration workflows and legacy metadata Utilize project management and tracking tools to...Full time
$74.16 - $107.75 per hour
...Description The Utilization Management (UM) Nurse supports appropriate levelofcare determination, patient flow, and revenue cycle integrity across... ...nursing care experience required. ~ Current valid CA RN license, required ~ BLS from the ARC or AHA, required. ~...Work at office$60 - $75 per hour
...Vision insurance Outpatient Case Management West Los Angeles VAMC 11301 Wilshire... ..., CA. 90073 There are five new RN vacancies at the West Los Angeles VA Medical... ...Opportunities Job Summary We are seeking a Utilization Management Nurse to join our team! As a...Hourly payTemporary workFor contractorsFor subcontractorWork at officeImmediate startRelocation packageMonday to FridayFlexible hoursShift work$116.3k - $264.6k
Yourcommission is seeking a Utilization Management Assistant Director in Los Angeles to lead Intensive Case Management and Utilization Management... ...improving patient outcomes. Ideal candidates possess a BSN, active RN license in CA, and experience in management roles within...
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