Medical Review Nurse $40,000 jobs in Cerritos, CA

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Grievance & Appeals Nurse (RN Preferred / Work from Home)
Facilitate medical necessity grievance, appeals and denials including disposition of denials notification letters, review of clinical information to determine...
Clinical Quality Assurance Nurse
Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews....
Concurrent Review Nurse II
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...
RN Clinical Staff Intensive Care Unit (ICU) Full Time Day
Electronic Medical Record experience preferred. The Clinical Staff Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for...
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Medical Claim Review Nurse

Molina Healthcare - 761 reviews - Long Beach, CA
Medical Claim Review Nurse - (1801312). Minimum one year Utilization Review and/or Medical. Serves as clinical liaison between the department and Corporate...

Medical Review Nurse Auditor - Southern California Home or O...

Qlarant - Cerritos, CA
Qlarant has exciting opportunities for Medical Review Nurse Auditors to join our Cerritos, CA based Unified Program Integrity Contractors (UPIC) team....
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Nurse Consultant

CVS Health - 20,076 reviews - Cerritos, CA
You provide Quality Reviews and other Omnicare nursing consultant services. You assist with activities associated in onboarding new facilities such as...

Master Trainer Nurse, Facility Site Review

Molina Healthcare - 761 reviews - Long Beach, CA
Experience conducting Quality Improvement activities such as medical audits, site reviews or utilization management activities....

Clinical Documentation Specialist (RN)

CalOptima - 31 reviews - Orange, CA
Utilization review experience is preferred. Responsible for creating a standardized audit tool for review of hospital, outpatient and professional claims to...
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Patient Care Advocate

WellCare - 867 reviews - Cypress, CA 90630
Preferred Licensed Practical Nurse (LPN). Preferred Licensed Registered Nurse (RN) Technical Skills:. Intermediate Ability to create, review and interpret...

Nurse Navigator

NantHealth - 28 reviews - Culver City, CA 90232
Review customer medical history. Coordinate medical affairs consults. Achieve positive reviews from clients with respect to service delivery....
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RN Clinical Services Trainer - Remote

Molina Healthcare - 761 reviews - Long Beach, CA
Assists Care Review Clinicians with methods to present cases at multidisciplinary rounds. Completion of an accredited Registered Nurse (RN) Program and an...

UM Coordinator

Advanced Medical Management - 20 reviews - Long Beach, CA 90815
Calls providers to obtain the supporting medical documentation needed for Prior Auth Nurse, and/or Medical Director to review....
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Quality Coord RN - Downey - Home Health

Kaiser Permanente - 6,653 reviews - Downey, CA
Designs, conducts and evaluates studies and problem focused reviews requested by the Medical Center Administration, medical staff, or department administrators...
UM Review Nurse - RN
IHHMG - Pasadena, CA 91106
$72,000 - $85,000 a year
Requirements for the Utilization Review Nurse*. Refers those requests that do not meet medical criteria review to the IHHMG Medical Director or Physician...
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Admission Care Manager (4p-12:30a)
Three (3) plus years of clinical experience in an HMO, medical group, affiliated model, hospital or medical office/clinic setting.License / Certification:....