Clinic RN - Health Care Clinic
Providence Health Plan Group
Description
Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members.
Qualifications
Nursing school graduate.
California Registered Nurse License upon hire.
3 years experience in utilization management and/or case management.
3 years clinical experience in hospital or medical office/clinic setting.
Experience with Milliman criteria.
Preferred Qualifications
Bachelor's Degree - Nursing or related field.
Certification in Case Management (CCM) upon hire.
Benefits
Providence offers a comprehensive benefits package including a retirement 401(k) savings plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, paid parental leave, vacations, holidays, health issues, voluntary benefits, well‑being resources and more.
Equal Opportunity Employer
Providence is an equal opportunity employer. We are committed to a workplace free from unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by law.
Location
Work Location: Facey Medical Foundation Admin Office-Mission Hills, CA Mission Hills 15451 San Fernando Mission Blvd.
#J-18808-Ljbffr Providence Health Plan Group
$30 - $34 per hour
A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying...SuggestedRemote jobHourly pay- ...healthcare organization is seeking a skilled professional to provide utilization review and coordinate care for members in California. The successful candidate will have a Nursing school degree and a California RN License. Key responsibilities include ensuring quality and...Suggested
$74.29k - $111.43k
Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for conducting real‑time clinical reviews to ensure the medical necessity... ...conferences. Qualifications Education - Registered Nurse (RN) with an active, unrestricted California nursing license required...SuggestedWork at office$27.61 - $53.83 per hour
...includes assessing services to ensure compliance with regulations and optimizing member outcomes through effective collaboration and review processes. Candidates should have at least 2 years of relevant healthcare experience, strong communication skills, and proficiency...SuggestedHourly payWork at office$26.41 - $51.49 per hour
...Healthcare in California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical service requests, ensuring... ...for healthcare delivery. The ideal candidate has an active RN license and at least 2 years of experience in hospital or managed...SuggestedHourly pay$85.7k - $128.54k
The Supervisor, Utilization Management (UM), reports to the Manager of UM and oversees the UM... ...department, including pre‑service and claims reviews. Supervise licensed and coordinator staff... ...: Active, valid, and unrestricted RN or LVN license in California (non‑compact...Remote jobLocal area$74.29k - $111.43k
NeueHealth in California is seeking a Concurrent Utilization Review Nurse responsible for conducting clinical reviews to ensure the medical necessity and appropriateness of services provided under a managed care plan. The role requires 2-3 years of clinical experience,...$27.02 - $48.55 per hour
...flexibility. Position Purpose Performs a clinical review and assesses care related to mental... ...data to improve quality and appropriate utilization of services Provides education to... ...Clinical Behavioral Health Professional or RN to join our team! The ideal candidate will...Hourly payFull timeContract workPart timeWork at officeRemote workFlexible hours$71k - $166k
...as needed to, the Clinical Manager/Charge RN acting as nurse manager, the Medical... ...concerns, issues, and questions including the review of patient satisfaction surveys. •... ...policies and procedures to facility staff. • Utilizes knowledge of FMCNA and FMS services and products...Temporary workWork experience placementWork at office- LaSalle Medical Associates IPA is seeking an On-Call Registered Nurse (RN) in California responsible for providing after-hours medical management coverage. This role involves supporting utilization management, care coordination, and urgent authorization tasks to ensure...Night shiftWeekend workAfternoon shift
- ...Qualifications Graduate of an accredited RN school of nursing. Current nursing... ...physical, mental, and emotional well‑being utilizing the nursing process of assessing, planning... ...beginning and ending of assigned shift. Reviews daily patient reports and assignments with...Shift work
$96.35 - $111.14 per hour
...and Ensure Quality Healthcare Practices: Review personal practices and support others to maintain... ...constructive conflict resolution. Utilize Technology: Learn and use available communication... ...Life Support BLS - Basic Life Support RN - Registered Nurse with state or compact...Hourly payFull timeRotating shift$85.7k - $128.54k
E2E Alignment Healthcare USA, LLC is seeking a Supervisor for Utilization Management in California. The role includes overseeing the UM department... ..., an accredited nursing background, and must hold an active RN or LVN license in California. Knowledge of Medicare Managed...- ...is seeking a Licensed Clinical Behavioral Health Professional or RN to assess care related to mental health and substance abuse.... ...role involves evaluating treatment needs, performing authorization reviews, and improving service quality. Ideal candidates should have strong...Remote jobFlexible hours
$20 - $75 per hour
Freelance Medical Reviewer, MyHealthTeam Swoop and MyHealthTeam, a Swoop company, transform the healthcare journey for millions of patients nationwide with innovative solutions. We’re committed to building an inclusive space where employees are valued for their unique...Hourly payExtra incomeFreelanceRemote work$172.36k - $258.55k
...leading healthcare company is seeking a Physician Advisor for Utilization Management. The role requires a California license and significant... ...utilization management. Responsibilities include processing reviews, liaising with medical staff, and overseeing case management...Remote job$30.77 - $44.52 per hour
...Medical Management Specialist-LVN is responsible for supporting the utilization management processes related to coverage decision, managing... ...items and/or services. Conducts pre-service and concurrent review following established guidelines in collaboration with Medical...Hourly payRemote workMonday to Friday$2,671.2 - $3,579.2 per month
...Health Facility (PHF) is seeking nurses (RN) to provide direct client care to patients... ...counts as required; organize, assign, review and evaluate staff work on scheduled shifts... ...counseling; infectious disease knowledge; utilization of documentation standards and customer...Hourly payPermanent employmentFull timePart timeWork at officeTrial periodShift work$130k
...established patients for follow-up management, including medication review, monitoring and maintenance of pain management including... ...assist PRS personnel in clinical decision-making and to optimize utilization of medical services. Programs. Employee shall participate in...Full timeWork at officeImmediate start- Overview Dane Street is an Independent Review Organization and a national provider of Utilization Review services. We are expanding our physician panel with opportunities for non-traditional physician work and supplemental income. This is a telework opportunity for physicians...Extra incomeContract workRemote work
- ...savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation... ...Pre-Placement Health Evaluation Details of each policy may be reviewed by visiting the following page - Closing Statement: The University...Local area10 hours per weekShift work
$60 - $80 per hour
...services, and other clinical and administrative responsibilities. Utilizing the guidelines set forth by the American Academy of Pediatrics... ...to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-1...Hourly payFull timeImmediate startFlexible hoursShift work- ...savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation... ...Pre-Placement Health Evaluation Details of each policy may be reviewed by visiting the following page: . Closing Statement The...Immediate startMonday to FridayShift workNight shiftAfternoon shift
$23.18 - $28.97 per hour
...location, operation of various materials handling equipment, and utilizing updating DoD MMIS records. Responsibilities Essential Job... ...updates to affected units, AFMED, and NGB/SGX Conduct monthly reviews, and provides monthly reports to the COR, of SLEP and DMLSS inventory...Hourly payContract workFor contractorsWork at office$45.05 - $72.08 per hour
...in routine oncology patient populations. Reviews lab diagnostic data and incorporates in... ...as required (i.e., IV therapy equipment utilization, universal precautions, body mechanics).... ...preferred. License & Certifications Valid CA RN license required. Basic Life Support (...Full timeShift work- ...experienced professional Registered Nurse (RN) responsible for excellence in the... ...nursing process as a problem solving model; utilizing their knowledge and experience to anticipate... ...for a specific patient population. Reviews all orders on patients and communicates changes...Hourly payFull timeLocal areaShift work
- MED SURG RN's Wanted. $5,000 Sign On Bonus Job Category : Nurse Requisition Number :... ...Nurse provides professional nursing care by utilizing the nursing process to care for patients... ...laws. For further information, please review the Know Your Rights notice from the Department...Full timeRelocation package
- ...st among Home Health Agencies. Positive reviews from patients and employees on platforms... ...Schedule: Saturday/Sunday What You’ll Do Utilize your outstanding clinical skills as you... ...Be a Success Current and unrestricted CA RN license Current BLS/CPR Certification Valid...Part timeLocal areaFlexible hoursNight shiftWeekend work
$51.88 - $76.28 per hour
...nurse case manager manages clinical resource utilization and documentation affecting reimbursement... ...Fair Chance Act. Essential Functions Reviews clinical information daily on each patient... ...of two (2) years’ experience as a RN, or two (2) years’ experience as a Case Manager...Shift work$73.44 per hour
...responsible for the planning and delivery of family‑centered patient care utilizing the nursing process: assessment, diagnosis, planning,... ...Pediatric Advanced Life Support (PALS); Registered Nurse - CA (RN). Preferred: Critical Care Registered Nurse. Work Environment &...Daily paidShift workNight shift
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