Utilization Review Nurse jobs in Los Angeles, CA

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RN Educator - Medical Management Training Specialist
L.A. Care Health Plan 9 reviews - Los Angeles, CA
Registered Nurses (RN) graduate; Three to five (3-5) yrs in managed care setting in Utilization Management/Case Management;...
Sponsored by L.A. Care Health Plan - 20 days ago
Regional Quality Manager Dialysis
Fresenius Medical Care 924 reviews - Los Angeles, CA
At least 2 years as a nephrology nurse. Conducts exit conferences with facility management staff to review risk assessment results and evaluation of QAI Program...
Sponsored by Fresenius Medical Care - 12 days ago

Utilization Review Registered Nurse Case Manager

Providence Health & Services 138 reviews - Mission Hills, CA
Providence is calling a Utilization Review Registered Nurse Case Manager to our Facey Mission Hills location in Mission Hills, CA....
1 day ago - save job - email - more...

Registered Nurse (RN) - Utilization Management Nurse Consult...

Aetna 397 reviews - Woodland Hills, CA 91367
Healthcare Management/Certified Utilization Review (CPUR) is desired. This position require familiarity with employment of inpatient care utilization guidelines...
1 day ago - save job - email - more...

Telephonic Utilization Management Nurse (RN) - Torrance, CA

Humana 751 reviews - Torrance, CA
Humana is seeking a Utilization Management Nurse who will collaborate with other health care givers in reviewing actual and proposed medical care and services...
14 days ago - save job - email - more...

Care Coordinator

NaviHealth 8 reviews - Los Angeles, CA - +1 location
Complete Utilization Management functions for authorizations. The health care team includes physicians, health plan UM/CM Nurse, hospital discharge planners,...
6 days ago - save job - email - more...

Northridge Renal Complex Case Management Nurse (RN) – Accoun...

CareNational Healthcare Services, LLC - Northridge, CA
$73,000 - $87,000 a year
1-2 years’ experience in managed care case management or utilization review is preferred, but not required. Valid, unrestricted state Registered Nurses (R.N.)....
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9 hours ago - save job - email - more...

Care Manager, LVN

Heritage Healthcare (SJHH) - Fullerton, CA 92835
Licensed Vocational Nurse. When performing Utilization review – will collect the necessary information regarding medical necessity using evidence based...
St. Joseph Health - 14 hours ago - save job - email - more...

Medical Program Manager - INTEGRATED TELECOMMUTING OPTION! (...

Health Net of California, Inc. - 4001 - Glendale, CA
Needs identification, development and implementation of utilization management, medical review, quality improvement and educational programs....
Health Net - 1 day ago - save job - email - more...

RN Case Manager

Providence Health & Services 138 reviews - Santa Monica, CA
Three years experience in case management, discharge planning, and/or utilization review experience. Current California Registered Nurse license....
6 days ago - save job - email - more...

RN Case Manager / Utilization Review

California Hospital Medical Center 440 reviews - Los Angeles, CA 90015
Registered Nurse in the State of California. 3 -5 years prior Utilization Management/Case Management experience....
Dignity Health - 13 days ago - save job - email - more...

Case Manager - RN

SOUTHERN CALIFORNIA HOSPITAL AT CULVER CITY 2 reviews - Culver City, CA 90232
D) Utilization review. A professional nurse (RN) assigned to conduct assessments for appropriateness of admission, continued stay and to prepare the patient for...
Brotman Medical Center - 9 days ago - save job - email - more...
RN Utilization Specialists
Medical Professionals 13 reviews - Los Angeles, CA
$125,000 a year
Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent post-service and retrospective claims medical review....
Sponsored by TheLadders.com - 10 days ago
Medical Management Manager
AltaMed 8 reviews - Los Angeles, CA
Oversee activities of utilization review as applicable to delegated entities. Provide direction and education on managed care utilization review operating...
Sponsored by Nurse.com - 24 days ago
CASE MANAGER - CASE MANAGEMENT DEPT (8 Hour Varied - Per Die...
Placentia-Linda Hospital 758 reviews - Placentia, CA
Utilization Management supporting medical necessity and denial prevention. A) accurate medical necessity screening and submission for Physician Advisor review,...
Sponsored by Tenet Healthcare - 11 days ago

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Company with Utilization Review Nurse jobs
9 reviews
L.A. Care is a leader in developing new programs through innovative partnerships designed to provide health coverage.