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JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

Registered Nurse Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Evenings Job Description Join a team that's shaping the...

PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable...

Registered Nurse Specialist Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Nights, Variable Job Description Join a team...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Description: Job Summary: Collaborates with other educators, managers, physicians, and other healthcare providers to develop, design, deliver and evaluate/improve education strategies and programs/classes based on member/patient...

CVS Health is seeking an experienced RN Utilization Management Nurse Consultant for Medicare joint procedures. This remote, full-time role follows a Monday–Friday schedule (9:00 am–5:30 pm in your time zone) with occasional evenings/holidays,...

Make written and oral reports/recommendations to the attending physician, Medical Director, or the DON concerning the status and care of the residents. • Agree not to disclose resident's protected health information and promptly report...

Salary : $101,190.00 - $151,468.56 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: Y5134L Department: HEALTH SERVICES...

The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Care Manager Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will...

Job Opportunity Title RN Date Opened 03/18/2026 Job Type Local/Travel Contract Industry Health Care Work Experience 1+ year City Northridge State/Province California Country United States...

Job Description Work Schedule: Day/evening, you will work eight 10-hour shifts per pay period including weekend rotation. Holiday rotation required. Hours are based off the operational needs of the...

SCAN Health Plan is hiring a registered nurse for clinical review of medical claims and post-service appeals. You will analyze pre/post payments, perform audits, and apply CMS guidelines to determine medical necessity and appropriate care.

Job Description This position offers a blend of on-site and remote work, along with a $5,000 sign-on bonus for eligible new hires. If you're an experienced...

Job Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members. Providence caregivers are not...

Open Non-Competitive Job Opportunity Exam Number: Y5135L Filing Start Date: 03/03/2026, 8:00 A.M., PT Filing Dates: 03/03/2026, 8:00 A.M., PT, Until The Needs Of The Service Are Met And Is Subject To Close Without Prior Notice.

*Job Summary and Responsibilities* As our surgical services nurse at Glendale Memorial Medical Center you will prepare patients for surgical procedures and assist in the operating room to ensure they receive excellent nursing when they are at...

UnitedHealth Group is seeking a Hospice Afterhours Triage Nurse to coordinate after-hours hospice care needs and ensure continuity of care when centers are closed. You will respond to calls, perform skilled telephonic assessments, educate patients...

PIH Health seeks an RN Peer Review Analyst in Los Angeles to retrospectively review medical records, validate quality of care, and ensure documentation accuracy. You will audit charts for appropriate admissions and continued stay, collaborating...

Job DescriptionJob DescriptionBilingual Remote LPN/LVN - Clinical Interviewer100% Remote | $25-$26/hour | Monday-Friday 11:30 - 8 PM EST (Can reside anywhere in the U.S. to be considered)**Must be bilingual and hold an active LPN/LVN license to be...

Licensed Vocational Nurse (LVN) – Los Angeles, CA Local Pay: $31.50/hour - (W2) Join our team and make a meaningful impact by delivering exceptional care in a professional healthcare setting. We're looking for a dedicated and compassionate...

Job Title: Registered Nurse (Navy Nurse Corps) Category / Component: Officer • Both Overview Navy Nurse Corps Officers deliver professional nursing care to service members, families, and global communities in leading edge military medical centers,...

NaphCare is seeking an experienced Utilization Management Registered Nurse for a remote-based position supporting an Arizona team. NaphCare delivers healthcare to correctional facilities nationwide and offers strong benefits and professional...