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St Mary Medical CenterLong Beach,CA
*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...
Molina HealthcareLos Angeles,CA
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...
PIH HealthLos Angeles,CA
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California Hospital Medical CenterLos Angeles,CA
*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal health care professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...
FRESENIUSLos Angeles,CA
Dialysis experience required Western Regional Float, MULTI-STATE travel required PURPOSE AND SCOPE: The professional...
PIH HealthLos Angeles,CA
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Glendale Memorial Hospital and HealthGlendale,CA
*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...
US Renal CareVan Nuys,CA
Responsibilities: How you'll change lives ...
Ochsner HealthLos Angeles,CA
Supports the values of service excellence, teamwork, and integrity while managing patient care.Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers.Qualifications:Requires a current RN license, nursing diploma or...
HumanaLos Angeles,CA
Humana is seeking a Pre-Authorization Nurse for remote work to review prior authorization requests and determine appropriate care following guidelines. The role involves clinical judgment, data entry in management systems, and collaboration with...
University HospitalsLos Angeles,CA
University Hospitals is seeking a Registered Nurse to collaborate with the health care team to coordinate admissions, continued stays, and level-of-care decisions. You will communicate with patients and families to ensure timely care and proper...
Trinity Health Mid-AtlanticLos Angeles,CA
Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site training in Mishawaka, Indiana. The position emphasizes reviewing medical necessity, insurance requirements, and...
SmartRecruiters IncLos Angeles,CA
Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...
Martin Luther King, Jr. Community HospitalGardena,CA
POSITION SUMMARY Reporting to the Director, Ambulatory Services of Martin Luther King, Jr. Los Angeles (MLK-LA) Healthcare Corporation, the Ambulatory Clinical RN as the leader of the health care team, provides professional...
HumanaLos Angeles,CA
Humana is seeking a Pre-Authorization Nurse to review requests for medical necessity and level of care, working remotely from Virginia or a compact-licensed state. You will educate providers, document clinical data, and make independent...
Molina HealthcareLos Angeles,CA
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...
Medix™Los Angeles,CA
Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding...
CVS HealthLos Angeles,CA
CVS Health Corporation is seeking a RN-qualified professional to lead quality improvement initiatives and performance measurement within POSC, aiming to meet HEDIS and CAHPS goals. The role involves analyzing clinical workflows, implementing...
U.S. Army 6th Medical Recruiting BattalionLos Angeles,CA
U.S. Army Family Nurse Practitioners perform the highest level of quality care for Army Soldiers, retirees, and their families. If you are looking to combine your skills as a family nurse practitioner and your passion for...
Vivian HealthLos Angeles,CA
Case Manager Utilization RN, 32 Day Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate...
Virginia Mason Medical CenterLos Angeles,CA
As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity. You will perform concurrent reviews and engage with physicians...
PIH HealthWhittier,CA
The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...
Beth Israel Lahey HealthLos Angeles,CA
Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...
Kaiser PermanenteDowney,CA
Description: Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient...
Bon Secours Mercy HealthLos Angeles,CA
Bon Secours Mercy Health is seeking an RN Infection Prevention professional to manage system-wide IPC activities, ensuring compliance with regulatory standards. This role supports outbreak investigation, surveillance, and performance improvement...
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