Utilization Review Nurse jobs in Orange, CA

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Concurrent Review Nurse, RN
Inland Empire Health Plan - 72 reviews - Rancho Cucamonga, CA
$67,600 - $104,800 a year
Two or more years of utilization management/case management in a health care delivery setting, with an emphasis on Concurrent Review and utilization management....
UM Review Nurse - RN
IHHMG - Pasadena, CA 91106
$72,000 - $85,000 a year
Requirements for the Utilization Review Nurse*. We are looking for a Utilization Review Nurse to join our team!...
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Registered Nurse (RN) - Case Management-Utilization Review
$79,000 a year
Advanced Travel Nursing, one of the largest staffing firms for travel nurses in the nation, is currently seeking qualified applicants for several open Case...
UM Retro Review Nurse
Care1st Health Plan - 50 reviews - Monterey Park, CA
Minimum three (3) years prior utilization review experience required. Active California Nurse License (LVN or RN)....
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Utilization Review Nurse

Los Angeles County Fire Fighters Local 1014 H&W Pl... - El Monte, CA
$70,000 - $95,000 a year
Understanding of utilization review techniques, all aspects of medical review function, including pre-authorization, concurrent review and discharge planning....
Easily apply

QI Nurse Specialist (Model of Care Review)

CalOptima - 37 reviews - Orange, CA
The QI Nurse Specialist for Model of Care review is responsible for detailed and intensive investigation into cases referred to an Interdisciplinary Care Team...
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UTILIZATION REVIEW CLINICIAN

Beacon Health Options - 474 reviews - Cypress, CA
S/he will be completing telephonic screenings to determine beneficiary needs, risks and performing ongoing utilization review for continued treatment....

RN Care Coordinator - Utilization Review

St Mary Medical Center - Long Beach - 934 reviews - Long Beach, CA
Current Registered Nurse (R.N.). The RN Care Coordinator consistently conducts the utilization review process and the discharge planning process as required by...

LVN Utilization Review Representative-Care Coordination-FT,...

CHOC Children's - 136 reviews - Orange County, CA
Prior experience as Utilization Review nurse. Certification in Utilization Review and/or Case Management. Reporting to the leadership of Care Management and...

LVN Utilization Review Representative, Mental Health Unit, F...

CHOC Children's - 136 reviews - Orange, CA 92868
Prior experience as Utilization Review nurse. Certification in Utilization Review and/or Case Management. Reporting to the leadership of Care Management and...

LVN Utilization Review Representative-Care Coordination-FT,...

CHOC Children's Hospital - 136 reviews - Orange County, CA
Prior experience as Utilization Review nurse. Certification in Utilization Review and/or Case Management. Reporting to the leadership of Care Management and...

Medical Review Nurse Auditor - Cerritos, CA

Qlarant - Cerritos, CA
Qlarant has exciting opportunities for Medical Review Nurse Auditors to join our Cerritos, CA based Unified Program Integrity Contractors (UPIC) team....
Easily apply

Grievance & Appeals Nurse Specialist

CalOptima - 37 reviews - Orange, CA
Clinical review processes including how to analyze and research clinical issues. Conduct research on standards of practice, regulations and policy and...
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LVN Utilization Review Representative, Mental Health Unit, F...

CHOC Children's Hospital - 136 reviews - Orange, CA
Prior experience as Utilization Review nurse. Certification in Utilization Review and/or Case Management. Reporting to the leadership of Care Management and...
Registered Nurse
Participates in quarterly utilization review and chart audits (peer and self) for OBQI/OBQM as requested by Agency....
Long Term Care Review Nurse, RN
Inland Empire Health Plan - 72 reviews - Rancho Cucamonga, CA
$67,600 - $104,800 a year
Responsible for coaching the inpatient review nurse as the subject matter expert regarding the clinical review of skilled and custodial Members....