Medical Review Nurse jobs in Cerritos, CA

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RN - Utilization Review
As a Utilization Review Nurse, you will determine the medical appropriateness of inpatient and outpatient services by reviewing clinical information and...
Advanced Medical Reviews - Santa Monica, CA
The Clinical Quality Nurse works collaboratively with physicians as a medical review, quality assurance professional....
Easily apply
Utilization Management supporting medical necessity and denial prevention. Required qualifications include an active Registered Nurse license with at least two...
Sponsored by Tenet Healthcare

Clinical Appeals RN

UnitedHealth Group - 2,362 reviews - Cypress, CA
Perform reviews using applicable criteria. Review post service member and provider appeals. Discuss cases with medical directors when applicable Required...

Appeals Review Nurse

WellCare - 141 reviews - Cypress, CA
Applies accepted criteria to review process, utilizes the parameters and inputs review data into systems. Reviews and interprets a variety of instructions and...

Medical Records Review Nurse

Integrated Healthcare Holdings, Inc. - Santa Ana, CA
Completes medical record review as assigned. Current CA Registered Nurse License preferred, CA Licensed Vocational Nurse License required....

Case Management Nurse

McKesson - 1,208 reviews - Cerritos, CA
Accountability for processing referral/authorization requests, reviewing medical documentation, determining medical necessity and/or benefit determination,...

Quality Review Nurse

Citrus Valley Health Partners - 23 reviews - West Covina, CA
All (1) newly graduated nurses, (2) re-entry nurses, and (3) nurses new to the U.S. Provides expertise to the organization in the form of quality management...

Utilization Review/Management Intern

BSRC - Newport Beach, CA
Experience in providing utilization review. Registered Nurse with Psychiatric training and experience. Our Utilization Review Specialist is responsible for...
Easily apply

HEDIS Medical Record Abstractor (50 Temporary openings)

Health Net, Inc. - 8 reviews - Huntington Beach, CA 92647
Registered Nurse, Licensed Vocational Nurse, Medical Assistant, Medical Coder; Prior experience with medical records, medical record abstraction or review and/...


MemorialCare Medical Foundation - 3 reviews - Los Angeles, CA
Knowledge of medical terminology. In addition to multiple locations throughout Orange County, MemorialCare Medical Group offers Urgent Care Centers that are...

RN Case Manager

Olympia Medical Center - Los Angeles, CA
Complete concurrent review in Meditech daily on insurance, non-funded & MediCal patients, every other day for Medicare patients....
Easily apply

Registered Nurse TTS

Fresenius Medical Care - 1,411 reviews - Bellflower, CA
Staff Registered Nurse. Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System....
Nurse Practitioner - Per Diem
Medical and Dental Insurance. Participates in the improving the quality of care including participation in peer review, setting clinical standards for medical...
Care Management Recovery Advocate Registered Nurse ( Full Ti...
Review all denied services secondary to medical necessity, regardless of payer, and where appropriate. Current California Registered Nurse (RN) license....

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Company with Medical Review Nurse jobs
The 3rd largest not-for-profit U.S. health system, providing health care to our communities – especially to the poor and vulnerable.