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$88.85k
...required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing admission... ...physicians, house supervisors, and other hospital delegates to ensure that telephone triage results in...SuggestedFull timeAll shiftsShift workNight shiftAfternoon shift- Working Nurse in Los Angeles is seeking an experienced Utilization Management Nurse Specialist RN II for a full time role. You will coordinate and approve medically necessary referrals, ensure timely notification of determinations, and collaborate with clinical staff to...SuggestedFull time
- Working Nurse in Los Angeles, CA is seeking an RN II for Nights to manage utilization management admissions and transfer requests. This full-time role focuses on medical necessity reviews, timely determinations, and coordination with inpatient teams. The candidate should...SuggestedFull timeNight shift
$88.85k
RN Job Utilization Management Admissions Liaison RN II (Nights) Shift Full Time Nights Pay Range $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Job ID 13180 Location Los Angeles, 90017 Job Description The Utilization Management (UM) Admissions Liaison RN II...SuggestedFull timeShift workNight shift- Your Role The Delegation Oversight Utilization Management team is responsible for the organization, tracking and data entry of IPA Utilization Management audits, issues, complaints and monitoring. Identifies root cause of the problem and maintains monthly reporting that...Work at office2 days per week
$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$88.85k
RN Job Utilization Management Nurse Specialist RN II Shift: Full Time Pay Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Job ID: 13208 Location: Los Angeles, 90017 Job Description The Utilization Management Nurse Specialist RN II facilitates, coordinates...Full timeShift work- Blue Shield of CA is seeking an experienced Delegation Operations Nurse Auditor-LVN-Experienced to manage IPA Utilization Management audits, issues, complaints, and monitoring. You will identify root causes and maintain monthly reporting to track patterns of delegated entities...Work at office
$49.87 - $73.32 per hour
Float Pool Registered Nurse II - FT/Nights Job Category: Registered... ...Description Job Title: Float RN II - Float Pool RN II:... ...teaching and provides leadership by delegating and working cooperatively and... ...patients and family members. Utilizes white boards for patient communication...Hourly payFull timeTemporary workRelocation packageShift workNight shift$45.16 - $66.4 per hour
...Registered Nurse II Full Time: 3 shifts per week, weekend availability... ...care. The Registered Nurse, RN, coordinates care to achieve... ...and provides leadership by delegating and working cooperatively and... ...patients and family members. Utilizes white boards for patient...Full timeRelocation packageShift workNight shiftWeekend work- L.A. Care Health Plan is seeking a Clinical Policy Nurse II to lead analytical research and policy assessment affecting claims and Utilization Management. The role analyzes clinical, financial, and regulatory data to identify opportunities for improvement and cost containment...
$49.87 - $73.32 per hour
Charge Registered Nurse II - ED/FT/Nights Job Category: Registered... ...0 /Full Time Only The Charge RN with clinical and management... ...Organizes, prioritizes, and delegates unit workflow. Assists staff... ...patients and family members. Utilizes white boards for patient communication...Hourly payFull timeRelocation packageShift workNight shift$2,005 - $2,100 per week
...Registered Nurse (RN) | Utilization Review Location: Burbank, CA Agency: GQR Healthcare Pay: $2,005 to $2,100 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$3,499 per week
...Registered Nurse (RN) | Utilization Review Location: Los Angeles, CA Agency: GQR Healthcare Pay: $3,499 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Position TravelNurseSource...Full timeContract workLocal areaImmediate startShift workDay shift$2,126 - $2,221 per week
...Registered Nurse (RN) | Utilization Review Location: Burbank, CA Agency: GQR Healthcare Pay: $2,126 to $2,221 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- LA Care Health Plan is seeking an RN II for Managed Long-Term Services and Supports in Los Angeles. The nurse specialist applies advanced... ...care planning, and collaboration with providers to promote utilization of services such as CBAS, SNF, ICF/DD, CalAIM supports, and...
$116.3k - $264.6k
Utilization Management Assistant Director - RN Work Location: Los Angeles, CA Salary Range: $116,300 - $264,600 annually Posting Date: May 29, 2026 Join... ...Responsibilities Provide day‑to‑day leadership and oversight of Intensive Case Management (ICM) and Utilization...- 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...
- L.A. Care Health Plan in Los Angeles, CA is seeking an experienced Utilization Management Admissions Liaison RN II. You will review admission requests and higher level of care transfers from inpatient facilities, determine medical necessity, and communicate decisions to...
$88.85k
.... Job Summary The Clinical Policy Nurse RN II is responsible for analytical research,... ...accreditation requirements that impact claims, Utilization Management (UM) department and... ...active participation in state regulatory audits such as Department of Health Care Services...Local area$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- ...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
$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- ...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 Hospital...Full timeTraineeshipWork at officeLocal areaShift work
$88.85k
RN Job Care Management Specialist II (RN 12 month Contract) Shift Full Time Pay Range $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max... ...017 Job Description The Care Management Specialist II utilizes clinical skills and training to perform essential functions...Full timeContract workShift work- 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...
$2,632 per week
...Registered Nurse (RN) | Obstetrics/Gynecology Location: Glendale, CA Agency:... ...Coordinates care with other disciplines while utilizing critical thinking, professional and... ...in order to provide continuity of care. Delegates appropriately and coordinates duties of healthcare...Full timeContract workShift workNight shift$2,513 per week
...Registered Nurse (RN) | Obstetrics/Gynecology Location: Glendale, CA Agency:... ...Coordinates care with other disciplines while utilizing critical thinking, professional and... ...planning to provide continuity of care. Delegates appropriately and coordinates the duties...Full timeContract workShift workNight shift$2,632 per week
...Registered Nurse (RN) | Obstetrics/Gynecology Location: Los Angeles, CA Agency... ...care with other disciplines while utilizing critical thinking and independent judgment... ...planning to ensure continuity of care. Delegates appropriately and coordinates duties of healthcare...Full timeContract workShift workNight shift
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN II: Delegation Oversight & Utilization Audit. Be the first to apply!
- wound rn Los Angeles, CA
- entry level registered nurse Los Angeles, CA
- psych rn Los Angeles, CA
- non clinical rn Los Angeles, CA
- clinic registered nurse rn Los Angeles, CA
- outpatient surgery centers rn Los Angeles, CA
- part time rn Los Angeles, CA
- rn relocation bonus Los Angeles, CA
- registered nurse healthcare Los Angeles, CA
- rn relocation assistance Los Angeles, CA


