RN Utilization Review Specialist
CommonSpirit Health
CommonSpirit Health is seeking a Utilization Review Nurse to ensure healthcare efficiency at the Utilization Management Hub. You will review medical records, authorize services, and collaborate with medical teams to monitor patient care for quality and appropriateness. The ideal candidate possesses a strong clinical background, exceptional analytical skills, and must be a Registered Nurse with a current California license. This position involves every other weekend availability and is crucial for optimal patient care. #J-18808-Ljbffr CommonSpirit Health
$2,065 - $2,160 per week
...Registered Nurse (RN) | Utilization Review Location: Los Angeles, CA Agency: GQR Healthcare Pay: $2,065 to $2,160 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position Contract - W2 Case Management...SuggestedHourly payWeekly payFull timeContract workImmediate startShift work$2,065 - $2,160 per week
...Registered Nurse (RN) | Utilization Review Location: Los Angeles, CA Agency: GQR Healthcare Pay: $2,065 to $2,160 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position TravelNurseSource is...SuggestedHourly payWeekly payFull timeContract workImmediate startShift work$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$1,900 - $2,500 per week
...Job Description Job Description Job Title: Travel RN Case Management Utilization Review Location: Carmichael, CA Salary Range: From $1,900 to $2,500 per week Shift: 8-hour Day Shift (Monday to Friday) Duration: [Specify Number of Weeks] (Contract) Job...SuggestedWeekly payContract workRelocationMonday to FridayShift workDay shift$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 Requisition ID: 13077 Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142...SuggestedFull time- Cedars-Sinai in Los Angeles is seeking a utilization review nurse. The role involves validating patient placements, utilizing medical necessity... ...Qualifications include an associate degree in nursing, current RN state license, and relevant experience. Preferred candidates...Shift work
$55.55 - $79.06 per hour
Job Summary and Responsibilities As our Utilization Review Nurse at the Utilization Management Hub, you will be a critical guardian of healthcare... ...regarding review outcomes. Collaborate with facility RN Care Coordinators to ensure progression of care. Engage the second...Hourly payWeekend work- Cedars-Sinai in Los Angeles is seeking a Utilization Review Case Manager to validate and secure patient care placements based on national admission... ...Degree from an accredited nursing program and a California RN License. Prior experience in Case Management and Acute Care is...
- Providence is seeking an RN for a remote Utilization Review role. This per diem position involves conducting prospective, retrospective, and concurrent utilization reviews for Southern California ministries, requiring strong clinical expertise and a solid understanding...Remote jobDaily paid
$57.28 - $88.92 per hour
...Senior Living - Avon in Los Angeles seeks a qualified Registered Nurse to perform utilization review and coordinate care. The candidate must have a nursing school degree and a California RN license. The role requires 3 years of utilization management experience and...Hourly pay- JOB TITLE: Constructability Review Specialist Every day at CMTS, we undertake impactful infrastructure projects that positively impact lives... ...to employees depending on individual performance, employee utilization, attendance, tenure, and furtherance of other non-financial...Full timeInterim roleLocal area
$74.29k - $111.43k
...a better care experience for all. Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for conducting real‑time clinical reviews... ...conferences. Qualifications Education: Registered Nurse (RN) with an active, unrestricted California nursing license...Work at office- 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...
- Providence is seeking a skilled Registered Nurse in Los Angeles to perform utilization review and care coordination, ensuring quality and cost-effective care for members. The ideal candidate will possess a California Registered Nurse License, a bachelor's degree in nursing...
- Neuehealth is seeking a Concurrent Utilization Review Nurse in Los Angeles, CA. This vital role involves conducting real-time clinical reviews to ensure the medical necessity of healthcare services under managed care health plans. Responsibility includes collaborating...
$88.85k
...Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12988 Salary Range: $88,854.00 (Min.) - $115,509.00 (...Full time$19 - $25 per hour
...lives, and preserve the planet." What do our Innovation/Utility specialists do? The primary purpose of this role is to perform the dynamic... ...with disabilities. California residents click here to review your privacy rights. It is unlawful in Massachusetts to...Hourly payFull timePart timeLocal areaImmediate startMonday to Friday- Join the Clean Energy Revolution Become a Utility Permitting Senior Specialist at Southern California Edison (SCE) and build a better tomorrow. In this... ...and the likelihood of securing the required permits. Reviews permit applications, ensuring the accuracy and...Local areaRemote workRelocation
$88.85k
...net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary... ...telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians,...- ...America’s Best Hospitals! What You Will Do in This Role: The Utilization Review Case Manager validates the patient's placement to be at the most... ...required. Bachelors Degree in Nurse preferred. California RN License required. Experience Minimum of 2 years experience in...Daily paidSeasonal work
$200k
Constructability Review Specialist - General - Los Angeles, CA Full-Time | On-Site | Los Angeles, CA Why CMTS? Every day at CMTS, our team delivers infrastructure projects that positively impact lives and communities. With over 42 years of industry experience, CMTS has...Full timeInterim roleLocal area$74.16 - $107.75 per hour
Description The Utilization Review Nurse is part of the Utilization Management Department at the Resnick Neuropsychiatric Hospital, supporting... ...psychiatric nursing care experience required. Current valid CA RN license, required BLS from the ARC or AHA, required. Prior...Work at office$74.16 - $107.75 per hour
Description The Utilization Management (UM) Nurse supports appropriate level‑of‑care determination... ...roles for coverage purposes utilization review/payor authorization and patient placement... ...experience required. Current valid CA RN license, required BLS from the ARC or...Work at office$35 - $50 per hour
Job Title Nurse Chart Reviewer (Hybrid) Location West Hills/Canoga Park, CA 91305 Job Type Contract to Hire... ...appeals Required Qualifications Active LVN or RN license (California) 2+ years of experience in Utilization Management (UM) Hands-on experience with HMO/...Contract workTemporary work$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 team...Hourly payWeekend work- ...POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include... ...admissions with continued and extended hospital stays, and discharge review that determine medical necessity. The RN UM will complete and...Full time
$47.2 - $63.45 per hour
...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service... ...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years acute care nursing experience...Full timePart timeWork experience placementLocal areaShift work$45 - $50 per hour
RadNet, Inc. is seeking a Clinical Nurse Reviewer focused on auditing the IP UM process to ensure compliance with regulations. The role includes analyzing reports, conducting audits, and collaborating with teams for process improvement. The ideal candidate will have a...Hourly pay- ...and as directed. Supports the organization vision and mission. Utilizes knowledge of patient's age, developmental status, spiritual and... ...certificate. Licensure in the state of California as a Registered Nurse (RN). Proficient in oral and written communication skills. Ability...Afternoon shift
- ...financial group. Job Summary: Reporting to Principal Review Manager, the Principal Review Specialist is responsible for performing Transaction Review and... ...profit amounts necessary for our accounting department by utilizing and completing Trade Discrepancy Reports. They are...Work experience placement
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