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Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13208 Salary Range:...

Network Resident Housing Liaison The Network Resident Housing Liaison oversees compliance processes for InnovAge PACE/LIFE contracted facility providers. The Network Resident Housing Liaison (RHL) is responsible for compliance activities...

Position Title: Behavioral Health Nurse - Contract Position, Ventura, Ca Department: Clinical Services / Recuperative Care Reports To: Director of Nursing / Nursing Manager...

Overview At Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in the...

Become a part of our caring community Humana/iCare is seeking an RN Care Manager to join the team in the Family Care Partnership (FCP) program to provide services to members in Milwaukee and surrounding counties. Reporting to the Manager of Care...

Host Healthcare is the #1 ranked travel healthcare company in the U.S. with an immediate option for this RN position in Burbank, CA. Sign-up here to submit your application for this role or for more information about this role, contact a member of...

Research Nurse Healthy Brain Clinic in Long Beach is part of the Irvine Clinical Research site network, the largest of its kind on the West Coast. With 5 research centers in California, we are leaders in the search for new treatments in...

DescriptionThere's nothing more exciting and rewarding than being able to make a significant, positive difference in someone's life. At UCLA Health, you'll experience this joy every day while also enjoying the positive, supportive, and...

Location: Work from home (Pennsylvania) Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes Job...

Nurse Abstractor The Suicide Mortality Review (SMR) Program, within the Arizona Department of Health Services' Office of Fatality Review, conducts multidisciplinary reviews of suicide deaths to identify system gaps, risk factors, and...

Join Optum Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care,...

Lead a Team. Improve Lives. Shape the Future of Community-Based Care. Are you an experienced Registered Nurse leader who is passionate about coaching others, improving clinical quality, and making a meaningful impact in your community?

Bay Crest Care Center in Torrance, CA is seeking a Full-Time Case Manager (LPN/LVN) to join their healthcare team. The role involves managing resident care through various stages and collaborating with healthcare providers. Candidates must have...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted,...

Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We...

Army Public Health Nurse Job Overview As an Army Public Health Nurse, you'll assess health risks and implement programs to monitor the spread of disease. You'll promote wellness for Soldiers and their families while also informing policy and...

East Los Angeles Doctor's Hospital seeks a Nurse Case Manager to oversee clinical resource utilization and documentation impacting reimbursement. You will monitor patients, coordinate discharge planning, and partner with the care team to ensure...

Elevance Health is seeking a Medical Management Nurse for California HMO to review complex cases and determine medical necessity. You will work with providers to understand clinical pictures, apply guidelines, and advise Medical Directors on when...

OverviewSt. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the hospital...

Job Details Reviews payor denials and audits for potential lost revenue. Writes comprehensive, factual arguments to present to third-party payers, medical review boards, or other responsible parties applying clinical criteria to establish...

PRN Assessment Nurse The PRN Assessment Nurse is responsible for identifying current and future patient care needs; being able to recognize normal versus abnormal body physiology. The role requires critical thinking, attention to detail...

Job Description Schedule: The weekly schedule choice is either Monday - Friday 10am-7pm EST OR Tuesday - Saturday 9am-6pm EST A bit about this role: The Clinical Guide Part A will be part of the...

OverviewOur mission at Good Seed CDC is dedicated to improving the health status of our members through an integrated managed health care delivery system.Duties and ResponsibilitiesEngages patients and offers and/or facilitates care management...

Responsibilities Leads best practice implementation and patient care delivery systems across multiple locations.Delegates investigation and resolution of patient/family concerns regarding care and services.Facilitates physician and healthcare team...

AHMC HealthCare is seeking a Denials Case Manager, RN in San Gabriel, CA. This role involves appealing denials, working with revenue cycle teams, and ensuring compliance with medical necessity standards. Requires a graduate of an accredited RN...