Utilization Review Nurse
Working Nurse
Working Nurse in Los Angeles, CA, is seeking a Utilization Management Claims Review Nurse RN II to conduct clinical reviews of medical claims ensuring medical necessity, proper documentation, and accurate billing. The role supports payment integrity through retrospective and pre-payment reviews and ensures compliance with regulatory standards. The ideal candidate has at least 5 years of clinical nursing experience and 3+ years handling Medi-Cal/Medicare in a managed care setting, with strong #J-18808-Ljbffr
Vacancy posted 1 day ago
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- ...Working Nurse in Los Angeles, CA is seeking a Utilization Management Nurse Specialist RN II. This full-time position focuses on facilitating, coordinating,... ...and providers. You will monitor admissions, perform reviews, gather medical records, and work with the UM Manager...SuggestedFull time
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Los Angeles, CA1 day ago - ...Utilize clinical judgment to approve or deny outpatient medical services based on Medical Necessity Criteria for various Health Plans Complete prior authorization and retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services,...SuggestedLive inWork at office
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Monterey Park, CA5 days ago $88.85k
...RN Job Utilization Management Claims Review Nurse RN II Shift Full Time Pay Range $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Job ID 13266 Location Los Angeles, 90017 Apply at Website Email Recruiter Job Description The Utilization Management (UM) Claims...SuggestedFull timeShift workWorking Nurse
Los Angeles, CA1 day 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...SuggestedHourly payWeekend workAstrana Health
Monterey Park, CA2 days ago- ...UCLA Outpatient Clinics in Los Angeles is seeking a UM Denial Nurse Reviewer to apply clinical knowledge, policies, and regulatory guidelines to review adverse determinations and ensure accurate, timely notifications. The role involves reviewing denials for proper documentation...Suggested
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Los Angeles, CA2 days ago - ...Utilization Review NurseAstrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical...Live inRemote work
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Monterey Park, CA2 days ago $34 - $47 per hour
...Job Description Job Description Description Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for...Hourly payLive inWork at officeRemote workMonday to FridayShift workAstrana Health, Inc.
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Glendale, CA1 day ago$3,062 per week
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Glendale, CA1 day ago$2,288 - $2,358 per week
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Gardena, CA1 day ago$3,062 per week
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Los Angeles, CA1 day ago$2,450 per week
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Glendale, CA1 day ago$2,264 per week
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Los Angeles, CA1 day ago$2,780 per week
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Los Angeles, CA1 day ago- ...Registered Nurse (RN) | Wound/Ostomy Location: Lynwood, CA Agency: Prime Time Healthcare Pay: Competitive weekly pay (inquire for details) Shift Information: Rotating - 5 days x 8 hours Contract Duration: 52 Weeks Start Date: ASAP About...Weekly payFull timeContract workImmediate startShift workRotating shift
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Lynwood, CA1 day ago $2,255 per week
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West Hollywood, CA5 days ago$2,450 per week
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Glendale, CA1 day ago$2,593 per week
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Lynwood, CA1 day ago $2,270 per week
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Gardena, CA1 day ago$2,139 - $2,292 per week
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