RN Utilization Review Case Manager - Admissions & Denials
$55.56 - $85.96 per hourTorrance Memorial Medical Center
Torrance-Memorial-Medical-Center is seeking a Utilization Review Case Manager in Torrance, California. This role involves reviewing patient charts according to established criteria, validating admission status, and collaborating with payers to secure authorizations for clinical services. The ideal candidate will have a Bachelor’s Degree in Nursing, at least one year of case management experience, and a Registered Nurse License. We offer competitive compensation ranging from $55.56 to $85.96 per hour. #J-18808-Ljbffr
$55.56 - $85.96 per hour
...Rose Senior Living - Avon is seeking a Utilization Review Case Manager to conduct patient chart reviews and ensure proper admission status and level of care. The role involves collaborating with payers for clinical service authorization and adherence to quality standards...SuggestedHourly pay$55.56 - $85.96 per hour
...Under general supervision, the Utilization Review Case Manager (UR CM) performs review of... ...CM validates the patient’s admission status and level of care to... ...Competencies Attends denial management committee. Identifies... .... Collaborates with RN Case Managers and the Physician...SuggestedContract work$47.2 - $63.45 per hour
...for the quality and resource management of all patients that are admitted... ...from the point of their admission and across the continuum of the... ...admission and concurrent review of the medical record for the... ...Clinical Social Worker. However, RN Case Manager preferred. 3. Five...SuggestedFull timePart timeWork experience placementLocal areaShift work$2,600 - $2,850 per week
...Registered Nurse (RN) | Case Manager Location: Torrance, CA Agency: United Health... ..., timely discharges Conduct admission reviews and utilization reviews using InterQual and Medicare... ...plans Manage appeals, denials, and benefits eligibility tasks to...SuggestedFull timeContract workLocal areaImmediate startMonday to FridayShift workWeekend work$2,250 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Paramount, California. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 06/29/2026 ~...SuggestedTemporary workFor contractorsShift workWeekend work$56 per hour
...Position Summary The Utilization Review/Management Nurse is accountable for planning... ...to said guidelines for admission and continued stay reviews.... ...indicators Communicates denials and physician-related... ...Ensures timely referrals of cases to Physician Advisor and timely...Full timeLocal areaImmediate start$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$2,450 - $2,650 per week
...Registered Nurse (RN) | Case Manager Location: Torrance, CA Agency: United Health Care... ...patient care, conducting utilization review, and managing discharge planning while... ...eligibility, prior authorizations, and admission criteria Collaborate with interdisciplinary...Full timeContract workLocal areaImmediate startShift workWeekend workDay shift- ...Case Manager - RN Full Time Day Shift Job Category: Registered Nurse... ...manages clinical resource utilization and documentation affecting... ...Essential Functions: Reviews clinical information daily... ...(or earlier if needed) of admission to determine if the patient...Full timeShift workDay shift
- ...Summary The Utilization Management (UM) Registered Nurse (RN) is responsible for reviewing medical necessity, level of care appropriateness... ...closely with physicians, case managers, social workers, and... ...please visit Duties Perform admission, continued stay, and concurrent...Permanent employmentTemporary workImmediate startRemote workRelocation packageMonday to Friday
- ...Summary The Utilization Management (UM) Registered Nurse (RN) is responsible for reviewing medical necessity, level of care appropriateness... ...closely with physicians, case managers, social workers, and... ...limited to, the following: Perform admission continued stay, and...Permanent employmentTemporary workSeasonal workImmediate startRemote workRelocation packageMonday to Friday
- ...POSITION SUMMARY The RN Utilization Management (RN UM) functions as... ...: the e-TAR process, denials management, and the... ...the point of patient admission to discharge.... ...stays, and discharge review that determine medical... ...recent experience in Case Management or Utilization...Full time
- ...Now Acute Hospital Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations* Retrospective Review* Admission Criteria Care coordination Concurrent Review Continued Stay Reviews...Remote work
- ...Job Description Description: Travel RN Case Manager – Torrance, CA | 5x8 Days | Acute... ...| Epic REQUIRED Case Management | Utilization Review | Discharge Planning Brandon Boughton... ...care and discharge planning • Perform admission and continued stay reviews •...Hourly payContract workWeekend workDay shift
- ...Based on an initial review of member care needs at the time of admission, establishes a discharge/transition... ...and satisfaction while managing the cost of care.... ...continuity of care. Presents cases and participates in... ...unrestricted California RN license. Two (2) years acute...Local area
$61.98 - $86.73 per hour
...Description Title RN Case Manager III Location Long Beach... ...for education, monitoring, utilization and evaluation of medical outcomes... ...to the Clinical Pertinence Review Form. The case manager has... ...evaluate for appropriateness of admissions, continued stay, and...Full timeContract workRelocation packageShift work$108.81k - $175.76k
...Fbcm Manager Annual Salary Range: $108,805.00 - $1... ...-based care, including admissions at Torrance Memorial Medical... ...Home Health, Inpatient Case Management, inpatient... ...for concurrent review (MCG) Knowledge and... ...Bachelor's (Required) RN License CA (Required)...Work at officeWeekend workWeekday work- ...RN Case Manager Qualifications for RN Case Manager: The Case Manager... ...a continuum of care from admission through discharge for... ...Partners with medical staff, utilizes scientific evidence for best... ...employee performance through the review of completed work...Temporary workShift work
$110k - $135k
...RN Case Manager Home Health & Hospice About the Organization Our client is... ...episode of care for your patients from admission through discharge. You'll deliver... ..., approve orders, and perform utilization management review Monitor patient progress and adjust...Full timeMonday to Friday- ...Description Coordinates management of care and ensures optimum utilization of resources, service delivery... ...compliance with external review agencies. Provides... ...integration of functions of case management, utilization... ...have mininum 5 years recent RN Case Management...Local areaMonday to FridayShift work
- ...Travel RN Case Manager San Pedro, CA Heartline Staffing, in partnership with Purple Cow... ...hospital case management team focused on utilization review, care coordination, and discharge... ...care and discharge planning Conduct admission and continued stay reviews...Hourly payContract workWeekend workDay shift
$1,864 per month
...seeking an experienced Registered Nurse (RN) – Utilization Review to assess the medical necessity,... ...Communicate with physicians, case managers, and insurance representatives to validate... ...effective patient care Assist in denials management and appeals processing...Weekly payShift work- ...POSITION SUMMARY – RN Case Manager Coordinates management of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation...Shift workWeekend work
$38 - $41 per hour
...healthcare recruiting firm is aggressively seeking an Ambulatory Case Manager RN to join a large healthcare organization in California. This... ...care coordination, developing care plans, and conducting reviews, ensuring exceptional patient outcomes in a supportive work environment...Hourly payFlexible hours- ...functions typically considered to be case management, care coordination and/or utilization management, and discharge planning... ...Qualifications: Current CA RN license and maintain current Conversant... ...coordination, and/or utilization review Demonstrate the ability in collaborating...Monday to Friday
- ...functions typically considered to be case management, care coordination and/or utilization management, and discharge planning... ...: Current CA RN license and maintain current Conversant... ...coordination, and/or utilization review Demonstrate the ability in collaborating...Monday to Friday
- ...RN - Case Manager VIBRA TRAVELS is seeking a Case Manager to join our expanding network of... ...voluntary and regulatory agencies for review activities. Proficient in collecting... ...medical records. Knowledgeable in utilization review, medical terminology, appropriate...Hourly payContract workLocal area
$2,789 per month
...Nursing Profession RN Specialty Case Manager Job ID 18403330 Job... ...voluntary and regulatory agencies for review activities. Proficient in collecting... ...records. Knowledgeable in utilization review, medical terminology,...Hourly payWeekly payContract workLocal areaImmediate startShift work$2,423 per week
...Registered Nurse (RN) | Case Manager Location: Paramount, CA Agency: Cynet Health Pay: $... ...Coordinates management of care and ensures optimum utilization of resources, service delivery, and compliance with external review agencies. Provides ongoing support and...Full timeContract workTemporary workMonday to FridayShift work- ...functions typically considered to be case management, care coordination and/or utilization management, and discharge planning... ...Qualifications: Current CA RN license and maintain current Conversant... ...coordination, and/or utilization review Demonstrate the ability in...Monday to Friday
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