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Beth Israel Lahey HealthLos Angeles,CA
When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local to New England States for...
CVS HealthLos Angeles,CA
CVS Health Job Opportunity We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care...
Real Estate Education RocksLos Angeles,CA
Minimum QualificationsCitizen of the United StatesProficient in written and spoken EnglishParticipation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)Preferred...
Arizona Department of AdministrationLos Angeles,CA
Care Management Nursing Consultant Job No: 540542 Work Type: Full-time Location: REMOTE OPTIONS, PHOENIX Categories: Healthcare/Medical Professional Level, Healthcare/Medical Support...
talent4healthLos Angeles,CA
A healthcare staffing agency is looking for a Travel Nurse RN Clinical Document Improvement Specialist based in Tarzana, California. The role involves managing patient complaints, providing clinical oversight, and performing medical record...
Le CYR ConsultingLos Angeles,CA
Complex Medicare Claims Review Complex Medicare claims/prior authorization requests require the review of medical record documentation to determine the reasonableness and necessity of the billed service in accordance with Medicare rules...
University of Southern CaliforniaLos Angeles,CA
The University of Southern California is seeking a Nurse Manager responsible for 24-hour accountability for patient care and operational efficiency. The ideal candidate will lead the nursing staff, promote effective communication, and ensure...
Generis TEkLos Angeles,CA
Please contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Nikhil Jhajharia at email address [email protected] can be reached on # 630-576-1935. We have...
Elevance HealthLos Angeles,CA
Wellness Nurse Consultant Wellness Nurse Consultant Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office...
Oak St. HealthLos Angeles,CA
Join Us At CVS Health We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply,...
Carle HealthLos Angeles,CA
Overview Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation in the chart to support clinical care provided, including severity of illness and risk of mortality which...
North CarolinaLos Angeles,CA
Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...
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...
Broadway VenturesLos Angeles,CA
Remote Rn – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled...
West Coast UniversityLos Angeles,CA
West Coast University is looking for a Nursing Academic Specialist in Los Angeles, California. In this role, you will guide nursing students, enhancing their educational experience through targeted support and collaboration with faculty.
Elevance HealthLos Angeles,CA
Elevance Health is seeking a Nurse Appeals RN to work virtually full-time, with in-person training required. The role involves investigating medical necessity appeals requests and requires a high school diploma and 2+ years of managed care...
Vivian HealthBurbank,CA
RN Utilization Mgmt Full-Time Day POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include: the e-TAR process, denials management,...
Glendale Post Acute CenterGlendale,CA
The purpose of your job position as Care Coordinator Nurse is to provide direct nursing care to residents, including the coordination of care that is safe, timely, effective, efficient, equitable, and resident-centered. You are responsible for...
Aditi ConsultingLos Angeles,CA
Payrate: $60.00 - $62.00/hr. Summary: The main function of the nurse is to provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and...
Blue Shield of CALos Angeles,CA
Your RoleThe Clinical Quality Team is responsible for reviewing and abstracting medical records to capture data and to ensure accuracy and completeness. The Clinical Quality Reviewer - Nurse, Senior will report to the Manager, Clinical Quality...
VITAS HealthcareSan Gabriel,CA
Admissions Nurse The Admissions RN is a registered nurse and an Interdisciplinary Team member whose primary responsibility is to present VITAS services and philosophy to patients and families in a manner that results in the admission of...
Bristol HospiceLakewood,CA
Bristol Hospice seeks an Admissions RN in Lakewood, CA 90712, who is responsible for building community relationships and facilitating hospice care access. The ideal candidate will possess an RN license in California and demonstrate effective...
ActalentLos Angeles,CA
Urgent Hiring for "Remote Clinical Review Nurses" Job Description: Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital...
BlueCross BlueShield of South CarolinaLos Angeles,CA
Team Lead For Specialty Programs Acts as team lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving...
Cohere HealthLos Angeles,CA
Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

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