RN II: Delegation Oversight & Utilization Audit
L.A. Care Health Plan
L.A. Care Health Plan is hiring an RN II for Delegation Oversight Clinical Audit to ensure UM compliance across delegated entities. The role conducts audits, maintains tools, and collaborates with Plan Partners, PPGs and vendors to improve access and utilization performance. The position requires an Associate’s in Nursing, CA RN license, and 7+ years of clinical experience (3 in managed care). It offers a comprehensive benefits package and supports ongoing compliance initiatives. #J-18808-Ljbffr L.A. Care Health Plan
$88.85k
...achieve that purpose. Job Summary The Delegation Oversight Clinical Auditor RN II is responsible for ensuring that delegates contracted to perform Utilization Management (UM) functions on behalf... .../procedures/workflows/processes/audit tools necessary to meet the...Suggested- Job Description The Delegation Oversight Clinical Auditor RN II is responsible for ensuring that delegates contracted to perform Utilization Management (UM) functions on behalf of L.A. Care (... ...procedures, workflows, processes, and audit tools necessary to meet those...Suggested
- Working Nurse in Los Angeles is hiring a Delegation Oversight Clinical Auditor RN II to ensure compliance with Utilization Management regulations. This role involves auditing delegates and working with Plan Partners to improve performance. Candidates should have at least...Suggested
$88.85k
...Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position... ...with physicians, house supervisors, and other hospital delegates to ensure that telephone triage results in...SuggestedFull time$88.85k
...required to achieve that purpose. Job Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of... ...with departmental expectations. Participate in audits, regulatory readiness activities, and quality...Suggested$88.85k
...income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures...Full time$102.18k
Clinical Policy Clinical Coder RN II Shift: Full Time Pay Range: $102,183.00 (Min.) -... ...interpreting, and operationalizing medical and utilization management policies to ensure accurate... ...processing, and effective utilization oversight. This position serves as a key clinical...Full timeShift work$102.18k
...Clinical Policy Clinical Coder RN II is responsible for analyzing,... ...operationalizing medical and utilization management policies to ensure... ..., and effective utilization oversight. This position serves as a... ...regulatory requirements into auditable tools. Ability to perform independent...- ...Makes appropriate assignments and delegates to other care providers as a... ..., provides nursing care utilizing the nursing process, including... ...patient population. Standard II. Patient Throughput & Patient... ...required ACLS required RN License in state of employment...ReliefLocal areaImmediate startShift work
$49.87 - $73.32 per hour
...Float Pool Registered Nurse II Job Category: Registered Nurse... ...Job Title: Float RN II - Float Pool RN II: Full Time... ...teaching and provides leadership by delegating and working cooperatively and... ...patients and family members. Utilizes white boards for patient communication...Hourly payFull timeRelocation packageShift workNight shiftWeekend work- RN Utilization Management (RN UM) Overview The RN Utilization Management (RN UM) functions as a support liaison for a variety of UM functions... ..., participants in team rounds to: (I) facilitate timely care, (II) assure quality of care throughout the hospital stay, and (III)...Full timeLocal area
- ...medical provider in California seeks an experienced Clinical Nurse II for the Oncology department. You will assess and manage the... ...of oncology patients, collaborate with healthcare teams, and utilize your RN competencies. The ideal candidate has an ADN, valid California...
$1,948 - $2,043 per week
...Registered Nurse (RN) | Utilization Review Location: Burbank, CA Agency: GQR Healthcare Pay: $1,948 to $2,043 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position TravelNurseSource is working...Hourly payWeekly payFull timeContract workImmediate startShift work$2,065 - $2,160 per week
...Registered Nurse (RN) | Utilization Review Location: Burbank, 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...Hourly payWeekly payFull timeContract workImmediate startShift work$141.97k - $156.55k
...Transplant Coordinator II - RN Join us in transforming lives every day. At OneLegacy, every moment counts. As the nation's largest... ...presentations about organ, eye and tissue donation. PTC-IIs are delegated the administrative authority, responsibility, and accountability...Full timeWork at officeShift workNight shift$102.18k
...Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management... ...reporting responsibilities, conducts regular audits to ensure compliance with community,... ...internal and external committees as delegated or assigned. Serves as a consultant...Full time- MDAEdge in Los Angeles is seeking a Utilization Management Policy Initiatives Nurse RN II, responsible for managing and creating clinical policies in compliance with state and federal regulations. The ideal candidate will have a strong background in clinical nursing and...
$48.39 - $53.6 per hour
...perform the following functions that are delegated and directed by a physician, if the orthopedic... ...Demonstrates knowledge and ability to utilize principles, practices, and techniques of... ...~ Bilingual (English/Spanish) Level II required. Preferred Qualifications:...Full timeTraineeshipWork experience placementWork at officeLocal areaShift work- ...The Research Nurse Coordinator II is responsible for all... ...care to research participants. Utilizes clinical nursing background and... ...of staff, and provides general oversight of research portfolio as it pertains... ...and Certifications RN State License - minimum Basic...Shift work
$116.3k - $264.6k
...centered care. UCLA Health is seeking a dynamic and experienced Utilization Management Assistant Director to oversee Intensive Case... ...care. Key Responsibilities Provide day-to-day leadership and oversight of Intensive Case Management (ICM) and Utilization Management...- L.A. Care Health Plan in Los Angeles is seeking a Utilization Management Admissions Liaison RN II responsible for overseeing inpatient admission requests and transfers. Candidates should have at least 7 years of clinical experience in an acute hospital setting and hold...
$2,746 per week
...B2B Staffing Services, Inc. is seeking a travel nurse RN Case Management Level II for a travel nursing job in Santa Monica, California. Job... ...services, and interdisciplinary teams Ensure appropriate utilization of healthcare resources while advocating for patients...Weekly payDaily paidContract workFor contractorsLocumFlexible hoursShift work$88.85k
RN Job Clinical Policy Nurse RN II Shift: Full Time Pay Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $... ...accreditation requirements that impact claims, Utilization Management (UM) department and... ...participation in state regulatory audits such as Department of Health Care...Full timeShift work$213k - $246.4k
...standards across the service line; delegating tasks related to the... ...appropriate assignment and utilization; managing the use and maintenance... ...by: providing additional oversight/span of control for, negotiating... ...procedures for preparing audit documentation, information,...Full timeTemporary workWork experience placementWork at officeLocal areaShift work- ...patient needs. Acts as a supervisor by assessing, planning, delegating and utilizing independent judgement in directing other healthcare employees... ...within six months of hire. Updated 12/09/09. Level II EQ Only: A minimum of two years of current Level III NICU experience...Hourly payFlexible hoursShift work
- ...Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation...Work at office
- ...patient needs. Acts as a supervisor by assessing, planning, delegating and utilizing independent judgement in directing other healthcare employees... ...obtain within six months of hire (updated 12/09/09). Level II EQ Only: A minimum of two years of current Level III NICU experience...Hourly payFlexible hoursShift work
- ...Nurse in Los Angeles is seeking a Clinical Policy Clinical Coder RN II to ensure accurate medical coding and compliance with... ...collaboration with stakeholders to implement policies and oversee utilization management. The ideal candidate has at least 8 years of clinical...Full timeShift work
$33 - $41 per hour
...Region is seeking a Registered Nurse (RN) Labor and Delivery for a nursing job in... ...as a supervisor by assessing, planning, delegating and utilizing independent judgement in directing... ...hire. Updated 12/09/09. Level II EQ Only: A minimum of two years of current...Hourly payShift work- ...patient needs. Acts as a supervisor by assessing, planning, delegating and utilizing independent judgement in directing other healthcare employees... ...obtain within six months of hire. Updated 12/09/09. Level II EQ Only: A minimum of two years of current Level III NICU experience...Hourly payFlexible hoursShift work
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