Home Health Virtual Care RN
Astrana Health
Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans. This position requires open availability between Monday through Sunday, 8 A - 8 P. You would be scheduled for 5 shifts per week. This is a remote position for CA-licensed nurses. Candidates must live in California. We are seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting. Our Values: Put Patients First. Empower Entrepreneurial Provider and Care Teams. Operate with Integrity & Excellence. Be Innovative. Work As One Team. Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment. Refer cases to Medical Directors as needed/appropri...Nurse, Medical Director, Medical Equipment, Healthcare, Patient
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Home Health Virtual Care RN in Monterey Park, CA vacancy
$30 - $34 per hour
...Center Dr., Monterey Park, CA 91754 Compensation: $30.00 - $34.00 / hour Department: Health Services (HS - UM) Job Title Utilization Management Review Nurse About the Role Astrana Health is looking for a Utilization Review Nurse to assist our Health Services Department...SuggestedHourly payWork at officeMonday to FridayShift work$34 - $47 per hour
UM Review Nurse - Remote Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Phillip Vasquez Compensation: $34.00 - $47.00 / hour Description Astrana Health is looking for a CA-licensed Utilization...SuggestedRemote jobHourly payFull timeWork at officeMonday to FridayShift work$27.61 - $53.83 per hour
...DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are... ...the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications • At...SuggestedHourly payContract workWork experience placementWork at officeMolina Healthcare
Commerce, CA5 days ago$34 - $47 per hour
Astrana Health, Inc. is seeking a CA-licensed UM Review Nurse for a remote position assisting the Health Services Department. Responsibilities include reviewing medical service approvals based on Medical Necessity Criteria. Ideal candidates will have at least one year of...SuggestedRemote jobHourly payShift work- ...to support clinical operations by conducting complex clinical reviews. The selected individual will use clinical judgment and collaborate... ...and Medi-Cal benchmarks. Applicants should have an accredited nursing degree and experience in healthcare or managed care settings....Suggested
$56 per hour
Position Summary The Utilization Review/Management Nurse is accountable for planning, directing, and overseeing aspects of daily Utilization Review... ...post‑acute services needed. Assists in preparing reports to UM Committee, including, but not limited to: McG/Interqual...Full timeLocal areaImmediate start$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 Contract - W2...Hourly payWeekly payFull timeContract workImmediate startShift workGQR Healthcare
Los Angeles, CA11 hours ago$1,983 per week
...Registered Nurse (RN) | Utilization Review Location: Los Angeles, CA Agency: GQR Healthcare Pay: $1,983 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position TravelNurseSource is working with...Hourly payWeekly payFull timeContract workImmediate startShift workTravelNurseSource
Los Angeles, CA2 hours ago$1,983 per week
...Registered Nurse (RN) | Utilization Review Location: Los Angeles, CA Agency: GQR Healthcare Pay: $1,983 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position Case Manager RN Job Location...Hourly payWeekly payFull timeContract workImmediate startShift workGQR Healthcare
Los Angeles, CA2 hours ago- Working Nurse is seeking a Utilization Management Claims Review Nurse RN II in Los Angeles. This full-time position involves clinical review of medical claims to ensure services are warranted and compliant with regulations. The ideal candidate will have at least 5 years...Full time
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Reliant Staffing Solutions
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Los Angeles, CA2 days ago$88.85k
...communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of medical claims to ensure services were medically necessary,...Full timeL.A. Care Health Plan
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$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...Hourly payWeekend workAstrana Health
Monterey Park, CA2 days ago- ...role supports clinical operations by conducting complex clinical reviews and coordinating care to ensure medical necessity and benefit... ...regulations. Required Qualifications Graduate of an accredited nursing program (ASN, ADN, BSN, or MSN). Bachelors preferred. Advanced...
$71k - $151k
Registered Nurse - Utilization Review Hospitals on Incredible Health are hiring and accepting applications in the Los Angeles, CA area. Work Details Shift(s) available: day shift Job types available: full time and part time Qualifications RN Diploma degree or higher from...Full timePart timeShift workDay shift- ...development ~ Vision insurance ~ Wellness resources About the Role: Join MedPOINT Management as a Medical Claims Clinical Review Nurse in Sherman Oaks, CA, where you'll play a crucial role in ensuring the quality and accuracy of medical claims. This is an...Remote work
MedPOINT Management
Los Angeles, CA18 days ago $37.6 - $78.35 per hour
...Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and regulations. This role involves evaluation clinical practices, identifying areas for improvement, and implementing...Hourly payWork at officeUCLA Outpatient Clinics
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$37.6 - $78.35 per hour
Description The Facility Site Review (FSR) Nurse is responsible for planning, coordinating, and overseeing Facility Site Reviews and Medical Records Reviews for the UCLA Medical Group provider network. This role supports compliance with healthcare standards, regulatory...Hourly payWork at office- The University of California - Los Angeles Health is seeking a Facility Site Review Nurse to plan and oversee site and medical records reviews, ensuring compliance with healthcare standards. This role involves coordination with provider sites, tracking audit results, and...
$37.6 - $78.35 per hour
Description The Facility Site Review (FSR) Nurse is responsible for planning, coordinating, and overseeing Facility Site Reviews and Medical Records Reviews for the UCLA Medical Group provider network. This role supports compliance with healthcare standards, regulatory...Hourly payWork at office$37.6 - $78.35 per hour
UCLA Outpatient Clinics seeks a Facility Site Review Nurse responsible for planning and overseeing Facility Site Reviews and Medical Records Reviews within the UCLA Medical Group. This position is vital for ensuring compliance with healthcare standards and promoting continuous...Hourly pay$145.69k - $218.07k
...Nurse-Midwife Salary: $145,687.20 - $218,074.56 Annually Location: Los Angeles County, CA Job Type: Full time Job Number:... ...requires referral to a physician. What You'll Be Doing: Reviews the patient's chart and searches for abnormalities that would indicate...Full timeNight shiftWeekend workAfternoon shiftGovernmentJobs.com
Los Angeles, CA1 day ago- ...What does a Nurse‑Midwife do? Under medical direction, provides care to mothers and babies through the maternity cycle of antepartum,... ...gynecological care, including family planning. What You’ll Be Doing: Reviews the patient’s chart and searches for abnormalities that would...Shift workNight shiftWeekend workAfternoon shift
County-of-Los-Angeles
Los Angeles, CA1 day ago $45 - $57 per hour
...receive a text message to schedule your interview. Registered Nurse (RN) at The Oncology Institute of Hope and Innovation... ...records your responses and may use automated tools to support the review of job-related skills. These tools do not make final hiring decisions...Hourly payFull timeTemporary workMonday to FridayShift workThe Oncology Institute of Hope and Innovation
San Gabriel, CA1 day ago- ...Aesthetic Nurse (Registered Nurse) Rejuve is recruiting expert aesthetic nurses to join our team! We are seeking registered nurses... ...Maintain a safe, secure, and clean environment for patients Review each patient's records pre and post treatment Effectively communicate...Full timeContract workPart timeFlexible hours
Rejuve MD
Los Angeles, CA2 days ago
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