Nurse Utilization Review & Care Coordination
Cedars-Sinai Medical Center
Cedars-Sinai is seeking an Utilization Review Case Manager to assess medical necessity and optimize patient care. You will collaborate with physicians, care teams, and payers to secure timely authorizations and coordinate discharge planning in a fast-paced hospital setting. Ideal candidates bring 3+ years of acute nursing and 2+ years in case management, with strong clinical judgment and communication skills. Licensure as an RN is required, CPT coding experience preferred. #J-18808-Ljbffr Cedars-Sinai
- L.A. Care Health Plan in Los Angeles, CA seeks an Utilization Management Nurse Specialist RN II to coordinate and approve referrals that meet criteria. You will monitor inpatient admissions, conduct telephonic or onsite reviews, and collaborate with on-site staff to discharge...Suggested
- ...Position Summary The PACE Utilization Review Specialist – RN oversees... ...the Program for All-Inclusive Care for the Elderly. The position... ...appropriate, cost-effective, and coordinated. This role works closely... ...of an accredited school of nursing with a current unencumbered...SuggestedWork at office
- Working Nurse in Los Angeles is seeking an experienced Utilization Management Nurse Specialist RN II for... ...full time role. You will coordinate and approve medically... ...experience and a solid acute care RN background. The role... ...transfer for medical reviews, in a #J-18808-Ljbffr...SuggestedFull time
- ...Utilization Review Case Manager The Utilization Review Case Manager is... ..., and efficiency of patient care services. Utilizing evidence... ...closely with physicians, care coordinators, payers, and the interdisciplinary... ...Uses clinical knowledge and nursing expertise to conduct initial...SuggestedNight shift
- ...Nurse Manager Manages the day-to-day operations of the Utilization Management Program in the Service Area or a... ...effective and quality patient care by appropriate... ...disciplinary teams to plan and coordinate care across the... ...regarding utilization review, care coordination,...SuggestedLocal area
$88.85k
...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position... ...(Min.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by...Full time- L.A. Care Health Plan in Los Angeles, CA is seeking a Utilization Management (UM) Claims Review Nurse RN II to evaluate medical claims for medical necessity, documentation, and proper coding. This role supports payment integrity through pre-payment and retrospective reviews...
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of active duty and eligible...Remote jobWork from homeMonday to Friday
- Job Description The Utilization Review Case Manager is responsible for assessing... ..., and efficiency of patient care services. Utilizing evidence... ...with physicians, care coordinators, payers, and the interdisciplinary... ...Graduate of an accredited nursing program - minimum Bachelor'...Night shift
$22.88 - $35.55 per hour
Q8511 - Staffing Coordinator CM1726872000 Job Summary The... ...provide support to the Nursing Supervisors, Managers,... ...for staff as assigned Utilize timekeeping, scheduling... ...Daily Operations - 30% Review and respond to all written... ...of USC, a 343-bed acute care hospital, provides...Hourly payDaily paidWork experience placementWork at officeLocal areaFlexible hoursShift workRotating shift- NeueHealth is a value-driven healthcare company focused on delivering high-quality, coordinated care. The UM Nurse role promotes quality, cost-efficient outcomes by coordinating across care settings, identifying member needs, planning care, and monitoring interventions...
- ...The Research Nurse Coordinator III is responsible for all activities associated with... ...work to provide hands-on clinical care to the research participants. Utilizes clinical nursing background and... ...guidance, instruction, training, work-review and leading staff. Thank you...Full time
- ...Research Nurse Coordinator III Grow your career at Cedars-Sinai! The Angeles... ...to make advances in cancer care. Join our team and... ...the research participants. Utilizes clinical nursing background... ...instruction, training, work-review and leading staff. Primary...Full timeRelocation package
- ...highest-quality medical care in Los Angeles. We... ...assessing their needs, coordinating care, communicating with... ...including concurrent review to determine the appropriateness... ...guidelines to conduct utilization review as is... ...transitioning to the Skilled Nursing Facilities, refers to...Seasonal workDay shift
- Kaiser Permanente in Los Angeles is seeking a Registered Nurse to work in Utilization Management and discharge planning. The role collaborates with an MD to coordinate admission decisions, plan safe transitions, and ensure regulatory compliance while optimizing resource...Full time
- ...highest‑quality medical care in Los Angeles. We... ...assessing their needs, coordinating care, communicating with... ...including concurrent review to determine the appropriateness... ...guidelines to conduct utilization review as is... ...transitioning to the Skilled Nursing Facilities, refers to...Day shift
- ...Opportunities Job Summary We are seeking a Utilization Management Nurse to join our team! As a Utilization... ...team, you will be responsible for reviewing patient files and treatment methods... ..., and that all patients under our care are receiving the necessary...For contractorsWork at officeImmediate startRelocation packageMonday to FridayFlexible hours
- L.A. Care Health Plan in Los Angeles, CA seeks a Utilization Management Nurse Specialist RN II to facilitate and approve referrals that meet criteria, coordinate admissions, and advise on discharge planning. You will work with the UM Manager and Physician Advisor, handle...
$60 - $75 per hour
...Utilization Management Nurse We are seeking a Utilization Management Nurse to join our team! As a Utilization... ...team, you will be responsible for reviewing patient files and treatment methods... ..., and that all patients under our care are receiving the necessary...Hourly payWork at officeFlexible hours$58.98 - $78.67 per hour
...Responsibilities As our RN Care Coordinator, you will be a central figure... ...collaborating with physicians, nursing, departments, insurers, and... ...of care and appropriate utilization of inpatient resources using... ...reliability test for Utilization Review product(s) used. Able to...Relocation package- ...Role Join myPlace Health as a Registered Nurse - Utilization Management in Los Angeles, CA. myPlace... ...providing value-based, comprehensive care and coverage for older adults with significant... ...Conduct utilization reviews for medical services to ensure alignment...Full time
$67.5 - $75 per hour
VetJobs is seeking a Utilization Review Case Manager in Los Angeles, CA to... ...assess medical necessity and care levels using InterQual, MCG,... ...collaborate with physicians, care coordinators, and payers to secure timely... ...license, 3 years of acute nursing, and 2 years in case...Hourly payNight shift$139.3k - $160.09k
...Nurse Director of Case Management Utilization Review —ignite an impact-driven leadership career in a high-acuity Southern California hospital . The Nurse... ...Case Management Utilization Review will champion care coordination excellence, operational efficiency, and patient-...Full timeRelocation packageWeekend work- ...Bed Control Coordinator RN Hours are 9am - 9:30pm... ...with available patient care units, coordinating emergency... .... Works closely with nursing, EVS and leadership to... ...and family members. Utilizes white boards for... ...further information, please review the Know Your Rights...Full time
$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$30 - $35 per hour
...services in our recuperative care centers, emergency... ...The Medical Coordinator is responsible for delivering... ...’s providers and reviewing medication list Establish... ...upon admission Utilize infection control measures... ...nights Home Health nursing experience and...Hourly payWork at officeNight shiftDay shiftAfternoon shift$26.35 - $39.53 per hour
...consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of... ...all. SCOPE OF ROLE The role of the UM Nurse is to promote quality, cost-effective outcomes... ..., or concurrent medical necessity reviews for an assigned panel of members...Hourly payContract workFor contractorsFor subcontractorWork at office- ...Job Description Medical Coordinator/LVN The Medical... ...works in our Recuperative Care Program to provide post... ...case conferencing, board review team meetings, monthly... ...with LVN manager, Nurse Practitioner Administrator... ...up to 50 pounds. Must utilize conversational speech for...Work experience placement
$26 - $28 per hour
...SPECIAL SERVICE FOR GROUPS, INC. JOB ANNOUNCEMENT Title: Animal Care Coordinator / Case Manager Division: HOPICS FLSA: Non-Exempt, Full-Time... ..., and program development activities. Screen participants utilizing CES assessment tools, including VI-SPDAT, VI-F-SPDAT, and...Hourly payPermanent employmentFull timeInterim roleWork at office$47.2 - $63.45 per hour
...for high quality and compassionate medical care. St. Francis is recognized for its full... ...and comprehensive admission and concurrent review of the medical record for the medical... ...post-graduation of an accredited school of nursing and a current state Registered Nurse license...Full timePart timeWork experience placementLocal areaShift workAfternoon shift
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