Utilization Review Nurse jobs in Los Angeles, CA

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Nurse Reviewer Specialty- AIM Glendale (125221)
Anthem, Inc. - 1,875 reviews - Glendale, CA 91205
Experienced Nurses join AIM as Nurse Reviewers. Nurse Reviewer I or Nurse Reviewer Associate. Nurse Reviewer I position:....
Registered Nurse Case Manager
Care Navigators on Demand - Northridge, CA
Registered Nurse (RN). Active CA Registered Nurse. Evaluates and verifies employee performance through the review of completed work assignments and work...
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Registered Nurse
Reviews and revises service plan as indicated; We are currently seeking Registered Nurses for all shifts, both full-time and part-time....

Utilization Review Nurse

Oscar Insurance - 10 reviews - Los Angeles, CA
Utilization Review Nurse. As a Utilization Review Nurse, you will determine the medical appropriateness of inpatient and outpatient services by reviewing...

Utilization Review RN Case Manager - Los Angeles

Providence Health & Services - 724 reviews - Los Angeles, CA 90006  +1 location
*Providence is calling a Utilization Review Nurse Case Manager (Full Time/Day Shift) to our Providence Medical Institute Axminster Managed Care location in Los...


Los Angeles County Department of Human Resources - 4 reviews - Los Angeles, CA
$75,845 - $110,492 a year
Participating in conducting prospective, concurrent, and retrospective utilization reviews of patient services or hospitalization to maintain quality of care...

Telephonic Nurse Case Manager

EK Health Services - Los Angeles, CA  +1 location
EK Health Services has built a reputation for offering superior, goal-oriented Workers' Compensation case management, utilization review, and bill review...
Easily apply

Appeals Registered Nurse Reviewer

Magnova Care - Pasadena, CA
Unrestricted valid CA Registered Nurse license. Performs retrospective, post discharge, and post serviced medical necessity review to determine appeal potential...
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Care Management Specialist - LVN

L.A. Care Health Plan - 33 reviews - Los Angeles, CA 90017
Certified Nurse Practitioner. Nursing - Licensed Vocational Nurse. Care Health Plan members under the direct supervision and management of a Registered Nurse...


Los Angeles County Department of Human Resources - 4 reviews - Los Angeles, CA
$90,563 - $131,934 a year
To nurses including registered nurses. Evaluates and reviews evaluations of employee performance. Two years of experience as a registered nurse providing direct...

Complex Case Management Nurse

Care1st Health Plan - 22 reviews - Monterey Park, CA
Licensed as an active California registered nurse or vocational nurse. Polypharmacy utilization consisting of >30 prescriptions per quarter....

Medical Review Nurse

SCAN Health Plan - 47 reviews - Long Beach, CA 90806
Medical Review Nurse. Certified Professional Coder/Certified Professional Utilization Reviewer. Provide clinical review of medical claims and post service...

Medical Claim Review Nurse

Molina Healthcare - 327 reviews - Long Beach, CA
1-3 years clinical nursing experience, including 1 year Utilization Review and/or Medical Claims Review experience. Assists with Complex Claim review;...
Utilization Review Specialist
Behavioral Health Billing - Costa Mesa, CA
Utilization Review Specialist*. Communicate daily/or as required with the Utilization Review Director. On an ongoing basis, identify potential review problems...
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Registered Nurse (RN)
Arroyo Vista Family Health Center - Los Angeles, CA 90042
Performs nursing electronic health record (EHR) documentation reviews to assure compliance with EHR documentation policy and procedures....

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