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MercorLos Angeles,CA
About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .
OptumLos Angeles,CA
Explore opportunities with Amedisys, part of the Optum family of businesses. We provide home health, hospice and community-based services that help people receive quality care where they feel most comfortable: at home. Rooted in personalized care,...
Managed Medical Review OrganizationLos Angeles,CA
Managed Medical Review Organization is seeking a skilled registered nurse for a remote, home-office role. The position emphasizes telephonic/customer service, accurate documentation, and clinical review duties without face-to-face patient contact.
Virtual MedicalLos Angeles,CA
Virtual Medical is seeking qualified Registered Nurses to join our fully remote 24-hour On Call Center. We handle incoming calls for clients requiring immediate medical attention and provide assessment, guidance and disposition to the appropriate...
Essentia HealthLos Angeles,CA
Essentia Health in Duluth, MN is hiring for a Health Services professional to conduct Managed Care Programs in coordination with third party administrators. You will help implement referral, prior authorization, and precertification processes...
Children's Hospital Los AngelesLos Angeles,CA
Clinical Research Nurse I Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's...
IQVIALos Angeles,CA
IQVIA is seeking a Flex Nurse Educator to educate patients remotely and to provide in-field support as needed. This non-clinical role empowers patients to manage their disease and improve treatment compliance, with travel up to 50% and occasional...
4004 Aetna Medicaid AdministratorsLos Angeles,CA
CVS Health is recruiting for an RN Concurrent Review Nurse in a remote capacity, focusing on inpatient clinical expertise to ensure medically necessary care across the continuum. The role requires an active RN license and 5+ years of...
Aviary HealthLos Angeles,CA
Redesigning heart health via virtual cardiac rehab for older adults.Mission-driven team of clinicians and engineers.Responsibilities:Review EMRs to determine eligibility and create orders.Conduct video intake assessments and treatment...
Shield HealthLos Angeles,CA
What You'll Do As an Enrollment Nurse, your primary responsibility is enrolling patients in a chronic care management program. You'll call eligible patients, educate them about the program, answer questions, and assist interested patients...
Martin Luther King, Jr. Community HospitalHuntington Park,CA
8 Hours POSITION SUMMARY The Clinical Staff Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of patient care.
Novitas SolutionsLos Angeles,CA
Novitas Solutions, Inc. seeks a Clinical Review Nurse to review and substantiate medical determinations for health claims. You will assess medical necessity, service levels, and appropriateness of care under national and local policies,...
Elevance HealthLos Angeles,CA
Elevance Health is seeking a HEDIS Medical Record Review Project Nurse to support HEDIS data abstraction and quality review in a fully virtual role with occasional in-person training. The position requires residing in Florida, a BSN, and at least...
Executive Staff Recruiters / ESR HealthcareLos Angeles,CA
Clinical Review Nurse - Concurrent Review TX All On-site Share on Job Description Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday – Saturday 8am-5pm CST- schedule is firm- no flexibility...
Ochsner HealthLos Angeles,CA
Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers...
Amerit ConsultingLos Angeles,CA
Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management) .Candidate must be authorized to work in USA without requiring sponsorshipLocation: 100% Remote for California...
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...
trustaffLos Angeles,CA
Trustaff is seeking a travel nurse RN Clinic for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: ClinicDiscipline:...
Baptist HealthLos Angeles,CA
Baptist Health in Jacksonville, FL, is seeking a Registered Nurse for its Hospital At Home program. You will educate patients and families, advocate for patient needs, and coordinate care across medical and nursing teams in a home-based setting.
CVS HealthLos Angeles,CA
About This Role The Utilization Management Nurse Consultant utilizes clinical experience to assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members. This role is ideal for those looking to contribute to...
TriHealthLos Angeles,CA
TriHealth is seeking a Clinical Documentation Specialist RN to review inpatient records, ensuring accuracy of diagnoses, severity of illness and quality measures. You will educate physicians and nurses, collaborate with coding staff, and drive...
HumanaLos Angeles,CA
Humana is seeking a Behavioral Health Prior Authorization Nurse to join the Wisconsin Medicaid Market (iCare) team. This role involves reviewing the clinical appropriateness of prior authorization requests to ensure they meet medical necessity and...
Health Business SolutionsLos Angeles,CA
HBiz seeks a Clinical Appeals Nurse (RN) to remotely support revenue cycle operations. You will review denied claims for clinical accuracy, develop evidence-based appeal strategies, and draft payer-ready documentation to overturn denials and...
Centene Management Company LlcLos Angeles,CA
Centene Management Company LLC is seeking a Licensed Practical Nurse to analyze prior authorization requests and determine medical necessity in New York. You will work with healthcare providers and the authorization team to ensure timely,...
Health Care Service CorporationLos Angeles,CA
About HCSC At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be...

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