Medical Review Nurse jobs in Cerritos, CA

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Nurse Manager - Senior Mental Health
Orange County Global Medical Center - Santa Ana, CA
Manages unit productivity by daily review of productivity and providing variance explanations. Ensures staff participates in Customer Service initiatives,...
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Aesthetic RN
South Bay Med Spa - Torrance, CA 90505
Registered Nurse (RN). Clinical Skills, Bedside Manner, RN license, prior Medical Spa, Dermatology, or Plastic Surgery practice is a plus....
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Nurse Reviewer - AIM Glendale (124413)
Anthem, Inc. - 1,828 reviews - Glendale, CA 91205
Determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review....
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Medical Claim Review Nurse

Molina Healthcare - 305 reviews - Long Beach, CA
Minimum one year Utilization Review and/or Medical. Utilizes established criteria for review of complex medical claims and refers to Chief Medical Officer or...

Care Review Clinician, Prior Authorization

Molina Healthcare - 305 reviews - Long Beach, CA
Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program....

Medical Review Nurse - Medicare/Medicaid

Quality Health Strategies - Cerritos, CA
The Medical Review Nurse is a mid-level professional performing medical record and claims review for Medicare, Medicaid, and/or other claims data in order to...
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Women's Research Study Coordinator (LVN or RN)

T.H.E. Health & Wellness Centers - Los Angeles, CA
Registered Nurse (RN). Assist study participants in scheduling primary care visits to further discuss PrEP and other health care concerns with a medical...
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Clinical Appeals Representative - Cypress, CA

UnitedHealth Group - 4,481 reviews - Cypress, CA
Correct information from Member, Medical Groups, Providers and other. Grievance cases for the Coordinators, Nurses and Doctors to review for a....

Medical Review Nurse

SCAN Health Plan - 46 reviews - Long Beach, CA 90806
Provide clinical review of medical claims and post service appeals. Registered Nurse required. Conduct review of claims data and medical records to make...

Delegation Oversight Nurse

Molina Healthcare - 305 reviews - Long Beach, CA
Registered Nurse or Licensed Vocational or Practical Nurse graduate from an accredited school of nursing. Minimum one year Utilization Review....

Regional DME Manager - Downey

Kaiser Permanente - 4,030 reviews - Downey, CA
Medical record review as necessary to ascertain additional information necessary for completion of referral for ordering or for UM review for denial....

Nurse Navigator - Clinic - Surgery ENT - F/T - Days

UC Irvine Health - 10 reviews - Orange, CA 92868
$94,104 - $112,464 a year
Nurse NavigatorCost Center:. Clin Nurse 3 Supv NEXWorking Title:. Performs the appropriate utilization review functions on the managed population utilizing...

Registered Nurse (7a-3p) - Sign on Incentive

Snf Payroll - Long Beach, CA
Registered Nurse (RN). Participates in the nurse on-call system. Demonstrated competence of nursing skills within the applicable Nurse Practice Act and...
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Registered Nurse - Labor and Delivery - Full-Time - Non-Exem...
Minimum Qualifications Minimum Education Minimum Experience Minimum Field of Expertise Hospital Requirements •Current California Registered Nurse License...
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RN Clinical Quality Specialist - FT - 8 Hour Days
Keck Medical Center of USC - 36 reviews - Los Angeles, CA 90015
Current Registered Nurse License Minimum Experience/Knowledge:. Behind every patient success is the dedication of a unique team of skilled and talented...
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