RN Utilization Review Specialist
CommonSpirit Health
CommonSpirit Health's St. Mary Medical Center in Long Beach, CA, seeks a Utilization Review Nurse to safeguard clinical decision-making, regulatory compliance, and efficient resource use.
You will review medical records, authorize services, and prepare cases for physician review in partnership with UM teams, ensuring care aligns with established criteria. The role requires CA RN licensure, AHA BLS, and strong UM/regulatory knowledge, with sharp analytical and organizational skills to support
#J-18808-Ljbffr$30 - $45 per hour
...leading healthcare consulting agency is seeking an Operations Specialist III for a contract opportunity in Long Beach, CA. This role... ...Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation...SuggestedHourly payContract workRemote work$58.7 - $73.3 per hour
...RN Utilization ReviewInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future... ...than the posted range as permitted by law.As our Utilization Review Nurse at the Utilization Management Hub, you will be a critical...Suggested$23.2 - $30.1 per hour
Position Summary Under the direction of the Director/Manager of Case Management, the Utilization Review Specialist directs all back-office functions of the Case Management Department. Interfaces with all payors/providers requesting authorizations, medical records, and other...SuggestedFull timeWork experience placementWork at officeLocal area- NOR Healthcare Systems Corp. in Bellflower, CA is seeking an Utilization Review Specialist to manage back-office case management functions. You will interface with payors and providers for authorizations and medical records, ensure timely reviews, and support the team with...Suggested
$43 - $47 per hour
...Torrance, CA is seeking a Senior Healthcare Recruiter for a remote RN position. The ideal candidate will have at least 1 year of Home... ...must possess an active CA RN License. Responsibilities include reviewing and processing chart tasks in a back office setting. This is a...SuggestedRemote job$27.61 - $53.83 per hour
...DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services... ...teams to promote the Molina care model. - Adheres to utilization management (UM) policies and procedures. Required...Hourly payContract workWork experience placementWork at office- Job Overview:We are currently seeking a Senior Utility Estimation Specialist to join our team in Long Beach, CA. The ideal candidate will be responsible for accurately estimating utility costs for upcoming projects and providing recommendations for cost-saving measures....
- ...Provides support for clinical member services review assessment processes. Job Summary:... ...the Molina care model. Adheres to utilization management (UM) policies and procedures.... ...education and experience. Registered Nurse (RN). License must be active and unrestricted...Work at office
- ...rewarding career! Job Description Are you an experienced RN Case Manager / Utilization Review Nurse looking for a new opportunity with a prestigious... ..., discussions with the primary care physician and specialists and evaluation of the patient Identifies member needs...Full timePrivate practiceWork at officeMonday to Friday
$27.61 - $53.83 per hour
...Job Title Provides support for clinical member services review assessment processes. Job Description Verifies that services... ...teams to promote the Molina care model. Adheres to utilization management (UM) policies and procedures. Required Qualifications...Hourly payFull timeContract workWork experience placementWork at office$47.2 - $63.45 per hour
...achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.QualificationsEducation, Experience,...Full timePart timeWork experience placementLocal area- ...Position Summary: The Rehabilitation Specialist ensures child/youth voice is heard during... ...view of their culture and social world, utilizing strength-based solution-focused... ...Actively participate in team meetings, case reviews, and other opportunities to collaborate...Work at officeLocal areaTrial periodLong distanceShift work
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C.H. Robinson is looking for a Customs Specialist who will play a critical role in protecting... ..., but are not limited to, the following:Review and validate customs entry data to... ...customer service skills and follow up to be utilized with customers and the networkProven track...Hourly payWork at officeLocal areaRemote workWorldwide2 days per week3 days per week$38.61 - $55.86 per hour
...Twitter. The Job Provide clinical review of medical claims and post... ...coverage medical necessity, utilization, and appropriateness of care... ...) Nurse, Medical Management Specialist, Member Services, etc. Review... ...and active California RN License in good standing required...Hourly payFor contractorsLocal areaRemote work$25 per hour
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...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: Long Beach, CA... ...not required. The documentation system utilized is EPIC. Pre-approval for time off is at... ...management. Holiday time off requests will be reviewed separately when availability is clear....Full timeContract workShift workNight shiftWeekend work- ...Ocean Export SpecialistWe are hiring an experienced Ocean Export Specialist to manage international shipments directly from our Long Beach... ...cargo moving without delay.Master Proprietary Tech: Learn and utilize our in-house custom software to manage all international...Worldwide
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...Urgently hiring ROI specialist in Torrance, CA ONSITE M-F 8am-5pm Must have EPIC... ...both internal and external customer needs utilizing available resources Skills Emr,... ..., you acknowledge and agree that your application may be reviewed using AI tools....Contract workTemporary workImmediate start$85.42k - $113.19k
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...Title: Registered Nurse (RN) ICU Location: Long Beach, CA Department: Medical... ...experience, according to established standards utilizing the nursing process, within the scope of... ...unless waived by nurse executive council review. Graduated from an accredited nursing...Full timeWork experience placementRelocation packageShift workNight shift- ...SpecialistPosition Purpose:The Asset Protection Specialist is primarily responsible for preventing... ...assigned store/multiple stores. They utilize tools to minimize loss to the Company,... ...incidents of theft and fraud, reviewing CCTV and exception reports, monitoring the...
- ...welcoming new talents. SUMMARY The HSE Specialist I is responsible for assisting the HSE... ...investigations at LISI Aerospace by utilizing Safety Committee members in the accident... ...(co-)lead the HSE and energy management review LISI is an equal opportunity at will...Contract workWork experience placementLocal areaWorldwide
- ...QC Specialist Back to jobs QC Specialist Job details Posted 14 October 2026 Start date 04 January 2027 Salary Range... ...inspections and ensure that documentation is accurate and timely. Review Welding Procedures and Welder Qualifications to verify...Permanent employmentWork at officeLocal areaRemote work
- ...the department. On-call duties are not required. The documentation system utilized is EPIC. Pre-approval for time off is at the discretion of management. Holiday time off requests will be reviewed separately when availability is clear. No holiday time off can be...Temporary workLocumLocal areaShift workWeekend work
- ...RN Specialist CNALCM - Surgery/Neuro Team- Full Time - Day Providence Little Company of Mary in Torrance has been recognized as a Magnet hospitala prestigious designation from the American Nurses Credentialing Center (ANCC), which recognizes organizations that provide...Minimum wageFull timeLocal areaShift work
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...Senior Oncology Specialist - EMERALD - Los Angeles West Territory covers: Los Angeles, CA - Culver City, CA - Long Beach, CA - Torrance... ...Our Senior Oncology Specialists achieve territory sales by utilizing their Oncology background and experience to: Create and execute...Local areaRemote workRelocationFlexible hours$19.84 - $38.69 per hour
...inside look at the position and our organization. Find out more about the IRIS Consultant position by clicking on the link and then reviewing the job posting below. TMG is committed to maintaining a diverse and inclusive workforce and prioritizes helping staff have a...Hourly payWork experience placementWork at officeLocal areaRemote workWork from home- ...recruiter as an initial step in the application process. The tool does not make employment decisions, and all interview transcripts are reviewed by our recruiting team; applicants may opt out of the AI voice call and request to speak directly with a recruiter instead....Currently hiringWeekend work
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...Registered Nurse (RN) | Progressive Care Unit Location: Long Beach, CA Agency: Host Healthcare Pay: $1,817 to $1,970 per... ...was rated #1 in Nursing Satisfaction by MIT Sloan Management Review. No matter if you want to explore the other side of the country...Full timeContract workLocal areaImmediate startShift workNight shift
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