Utilization Review Nurse jobs in Los Angeles, CA

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Registered Nurse (RN) Utilization Management (UM) Nurse Cons...
Aetna 448 reviews - Woodland Hills, CA
Healthcare Management/Certified Utilization Review (CPUR) is desired. Minimum 3+ years of experience with utilization review in the hospital setting is required...
Sponsored by Aetna - 3 days ago
Abnormal Lab RN- Los Angeles, CA
Planned Parenthood Los Angeles 330 reviews - Los Angeles, CA
Minimum two (2) years of experience in utilization review, case management, and discharge planning preferred....
Sponsored by Planned Parenthood - 9 days ago
Utilization Review - Managed Care Nurse - (UL RN)
NursesRx 11 reviews - Pasadena, CA
Utilization Review - Managed Care Nurse - (UL RN). As a critical member of the hospital staff, the utilization review nurse is also responsible for:....
Sponsored by NursesRx - 9 days ago

UM Retrospective Review Nurse

Care1st Health Plan - Monterey Park, CA
Minimum three (3) years prior utilization review experience required. Active California Nurse License (LVN or RN)....

Registered Nurse (RN) Utilization Management (UM) Nurse Cons...

Aetna 448 reviews - Woodland Hills, CA 91367
Healthcare Management/Certified Utilization Review (CPUR) is desired. Minimum 3+ years of experience with utilization review in the hospital setting is required...

Manager, Utilization Review

L.A. Care Health Plan 10 reviews - Los Angeles, CA
Operations, reporting, and staff management of utilization review, case management, and coordination of linked and carved out service functions....

RN MEDICAL MANAGEMENT NURSE - Workers' Compensation

Zenith Insurance Company 23 reviews - Woodland Hills, CA
Maintain current unrestricted registered nurse (R.N.). Preference for previous insurance, managed care or utilization experience....

RN, Triage Nurse

Blue Shield of California 152 reviews - Woodland Hills, CA
Conducts assessment and quality reviews of the BSC transplant network. Case Managers perform a blended function of utilization management (UM) and case...

Concurrent Review Nurse - Encino, CA

Conifer Value Based Care - Encino, CA
Concurrent Review Nurse - Encino, CA. Conifer Health Solutions is currently hiring for a Concurrent Review Nurse....

RN, Care Manager

HealthCare Partners 73 reviews - Los Angeles, CA - +3 locations
Previous care management, utilization review or discharge planning experience. We are currently seeking a Registered Nurse, Care Manager:....

Prior Authorization Case Manager

Regal Medical Group - Covina, CA
Knowledge of NCQA, CMS, HSAG, and health plan requirements related to utilization management. The PACM will review for appropriate care and setting, and...
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Utilization Management Coordinator - Cypress (C02-103)

Beacon Health Strategies, LLC 12 reviews - Cypress, CA
The Utilization Management Coordinator is responsible for completing triage assessments to determine patient risk and appropriate level of care based on the...

Case Manager Nurse (LVN),

AltaMed Health Services Corporation 3 reviews - Los Angeles, CA 90012
May be responsible for daily concurrent reviews, retro reviews, discharge planning, pre-certification/prior authorization request review,and ensures patients...
Utilization Review Specialist - Behavioral Health
Sovereign Health Group - Los Angeles, CA
The Utilization Review Specialist’s - Behavioral Health role is to maximize reimbursement through effective utilization review and to ensure quality compliance...
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Sponsored by Sovereign Health Group - 30+ days ago
RN Healthcare Services Clinical Trainer
Molina Healthcare 125 reviews - Long Beach, CA
Records and trends individual and department review results on weekly, monthly, quarterly and annualized basis....
Sponsored by Molina Healthcare - 30+ days ago

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