Hybrid Utilization Review Nurse | Prior Authorization
$30 - $34 per hourAstrana Health
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. Candidates must have an active LVN license in California, experience in health plans, and strong interpersonal skills. Compensation ranges from $30.00 to $34.00 per hour with weekend and holiday coverage as needed. #J-18808-Ljbffr Astrana Health
$31.93 per hour
...forward every day. Job Overview The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from all lines of business using... ...managed care experience in Utilization Management/prior authorization required. A minimum...SuggestedHourly payFlexible hours$30 - $34 per hour
...Health Services (HS - UM) Job Title Utilization Management Review Nurse About the Role Astrana Health is... ...Health Services Department. This hybrid position requires availability... ...needed. What You’ll Do Complete prior authorization/retrospective reviews of elective...SuggestedHourly payWork at officeMonday to FridayShift work$31 - $45 per hour
...valid RN or LVN license in California and have at least two years of clinical experience. The successful applicant will work in a hybrid model, blending onsite hospital visits with home office work. Compensation ranges from $31 to $45 per hour depending on experience...SuggestedHourly payFull timeWork at officeWork from homeHome office- A skilled nursing facility in Los Angeles is urgently hiring for a hybrid Licensed Vocational Nurse (LVN) position. The role involves providing daily nursing care, monitoring vital signs, and ensuring compliance with health standards. A valid LVN license, CPR/BLS card,...SuggestedImmediate startDay shiftAfternoon shift
- ...with benefit requirements. You will collaborate with providers and interdisciplinary teams, coordinate discharge planning, reassess plans, and participate in a rotating evening and weekend on-call schedule in a hybrid virtual work model. #J-18808-Ljbffr Blue Shield of CASuggestedAfternoon shift
- ...Knowledge and Experience Associate Degree in Nursing required or master's degree in relevant... ..., government and commercial regulations, prior authorization processes, and level of care and length of stay criteria is preferred Hybrid Virtual Work This role allows employees...Full timeContract workWork at officeAfternoon shift
$135k - $145k
...regulatory requirements. In this hybrid role, you’ll split your time... .... Lead clinical eligibility reviews: Facilitate clinical eligibility... ..., helping present and review nursing recommendations for potential... ...necessary proof of vaccination prior to employment. Beware of Scams...Temporary workPart timeWork at officeLocal areaRemote workMonday to FridayFlexible hours- Cigna Health and Life Insurance Company is seeking a Cardiopulmonary Nurse Specialist (RN) to support patients with complex cardiopulmonary conditions in a field-based, hybrid role in Los Angeles. You will educate patients and caregivers, partner with PAH centers and pulmonary...
- ...CA is seeking an experienced Delegation Operations Nurse Auditor-LVN-Experienced to manage IPA Utilization Management audits, issues, complaints, and monitoring... ...quality improvement under UMDO leadership. This hybrid role requires in-office presence two days weekly and...Work at office
$37 - $50 per hour
...Clinical Denials Nurse (RN or LVN) Northridge, CA CareNational is looking for... ...experience) Work Setting: ~ Hybrid (both in-office and work from home)... ...healthcare field. Minimum of 3+ year of prior authorization/ denials experience Minimum of 1+ year...Hourly payImmediate startWork from home$110k - $120k
...that improve health outcomes. Ideal candidates possess a valid RN license, experience in care management, and strong communication skills. This position offers a hybrid working model with a salary range of $110,000 - $120,000 annually. #J-18808-Ljbffr Blue Zones Health- ...the primary contact, coordinating with doctors, social services, and caregivers to align on client needs and care plans. The role is hybrid (in-person and remote) with travel throughout the LA County area up to 5 days per week. Candidates must reside within 20 miles of...Remote work
- ...facilities and remote administrative tasks. Candidates should have at least an Associate degree in Nursing and three years of experience in care coordination. The position offers a hybrid work model, competitive salary, and benefits including paid time off and health insurance....Remote work
- ...Delegation Oversight Utilization Management team is responsible... ...Operations Nurse Auditor-LVN-Experienced... ...at least 3 years of prior relevant auditing experience... ...or prior out-patient authorization review preferred Desired... ...Power Point Skills Hybrid This role requires...Work at office2 days per week
- profoundtreatment is seeking a Nurse Practitioner specializing in Addiction Medicine to provide comprehensive care for individuals with... ...experience in addiction medicine. The position offers medical benefits, PTO, and a hybrid schedule. #J-18808-Ljbffr profoundtreatment
$200k - $250k
LifeStance Health seeks a Psychiatric Nurse Practitioner (PMHNP) for our outpatient group in Santa Fe Springs, CA. This full-time role... ...Compensation ranges from $200,000 to $250,000, plus a comprehensive benefits package and a hybrid work model. #J-18808-Ljbffr LifestanceFull timeRelocation packageFlexible hours- Mood Health is seeking a Psychiatric Mental Health Nurse Practitioner (PMHNP) for a dynamic role in Salinas, CA. This position involves... ...candidate will have an active PMHNP license, experience with hybrid care delivery, and a commitment to patient-centered practice. The...Remote jobFlexible hours
$45.98 - $59.9 per hour
...Registered Nurse APLA Health Center Mid Wilshire - Los Angeles... ...time frames with efficient utilization of resources. In addition,... ...to be rescheduled, by reviewing the medical record and determining... ...when indicated. Obtain prior authorizations for medications Contact...Hourly payFull timeWork at officeFlexible hoursShift work- ...Angeles is seeking a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) to join a new outpatient, insurance-based... ...mentorship from Dr. Mike Mah and a supportive team. The position offers hybrid care (telehealth and in-person at Century City), competitive W-2...Full timePart time
- LifeStance Health in Los Angeles, CA is seeking a Psychiatric Nurse Practitioner (PMHNP) for a full‑time, 30+ hour/week role in outpatient... ...a 401(k) match, CME allowance, and licensing dues coverage. Hybrid work model with some in‑office days. #J-18808-Ljbffr LifestanceFull timeWork at officeFlexible hours
- ...Overview The Licensed Vocational Nurse (LVN) reports to the Nurse Manager and... ...for reportable (+) STD's. Assists with Prior Authorizations. Reviews patient labs. Triages patient phone... ...patient problems and meets needs by utilizing multidisciplinary team strategies. Maintains...Flexible hours
- ...Registered Nurse As an integral part of the multidisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients and their... ...and sorting in-coming faxes, obtaining prior authorizations. Ensures patient's right to privacy,...Full time
- ...for clinical member services review assessment processes.... ...Conducts reviews to determine prior authorization/financial responsibility for... ...Molina care model. Adheres to utilization management (UM) policies and... ...experience. Registered Nurse (RN). License must be active...Remote jobWork at office
- PIH Health and Cerritos College invite applications for a Nursing Instructor to teach in the Associate Degree Nursing program, including... ...for day, evening, and weekend courses, in-person, online, or hybrid formats. The instructor will participate in curriculum development...Weekend workAfternoon shift
- ...Los Angeles LGBT Center in Los Angeles, CA is seeking a Manager, Nursing Case Management (RN) to provide direct supervision of the... ...industry standards and contractual requirements. This full-time, hybrid role reports to the Associate Director, Clinical Nursing and works...Full time
- Registered Nurse - Outpatient Clinic Location: Los Angeles, CA. Facility: Reconstructive... ...questions in a timely manner. Obtain prior authorizations and enter surgery referral requests.... ...and results received prior to surgery. Review consents and facilitate pre‑op and post...Local areaShift work
$53 - $87.45 per hour
...integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to... ...returning phone calls, triaging patient calls, and obtaining prior authorizations. Ensures patient's right to privacy, safety, and confidentiality...Hourly payFull timeWork experience placementLocal areaImmediate startDay shift- ...The Research Nurse Coordinator II plays a key role in the successful... ...; candidates must have prior experience working within clinical... ...to research participants. Utilizes clinical nursing background and... ...Qualifications This role follows a hybrid work schedule; however, we can...Full time
$28 - $47.75 per hour
...phone calls, receiving and sorting in-coming faxes, obtaining prior authorizations. Ensures patient's right to privacy, safety, and... ...Specialized/technical training Graduate from an accredited Vocational Nursing Program Req Ability to communicate effectively in English...Hourly payFull timeWork experience placementLocal area- ...Licensed Vocational Nurse II (LVN II) The Licensed Vocational Nurse II (LVN II) is... ...Nurse (RN) or Medical Provider. The LVN II utilizes the Nursing Process to provide... ...and sorting in-coming faxes, obtaining prior authorizations. Enters charges into the system in an...Full time
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