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Oak St. HealthLos Angeles,CA
Job Opportunity 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...
BrightSpring Health ServicesLos Angeles,CA
Our Company PharMerica Overview Join a team of passionate and caring clinicians who make a difference in people's lives. Our nursing group focuses on compassion and meeting the needs of our...
ActalentLos Angeles,CA
Clinical Review Nurse Duals Program Details- Brand new program of 2026 for Centene Duals = Medicare + Medicaid line of business. Members have one combined card and one authorization covering both benefit types. The duals...
UnitedHealth GroupLos Angeles,CA
Ssbv Clinical Claims Review Rn 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...
PacifiCare Health ManagementLos Angeles,CA
Pacificare Health Management is seeking a Nurse Consultant in Los Angeles, CA to provide support for long-term care facilities, ensuring compliance with regulatory standards. The role requires a Bachelor's degree in Nursing, with at least 5 years...
San Gabriel/Pomona Regional CenterMaywood,CA
Description: The Organization San Gabriel/Pomona Regional Center (SG/PRC) is a private, nonprofit agency contracted with the California Department of Developmental Services (DDS) to provide services and...
Sanford HealthLos Angeles,CA
Registered Nurse Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. The Center for...
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...
Gainwell TechnologiesLos Angeles,CA
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...
LifePoint HealthLos Angeles,CA
RN Clinical Documentation Improvement Specialist This is a REMOTE opportunity Your experience matters: Frye Regional Medical Center, located in the beautiful foothills of North Carolina is a 355-bed acute care hospital,...
L.A. Care Health PlanLos Angeles,CA
Managed Long Term Services and Supports Nurse Specialist RN II Job Category: Clinical Department: Managed Long Term Services and Supports Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition...
Guardian Life InsuranceLos Angeles,CA
RN Clinical Consultant The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding disability by providing comprehensive medical reviews and analysis of long-term and or...
Engage ConsultingLos Angeles,CA
Job Type Full-time Description REMOTE RN MDS CONSULTANT-Full Time Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, and Quality Measure experience to...
Virtual VocationsLos Angeles,CA
Providing clinical review support on an as-needed basis, the part-time PRN Clinical Review Specialist will review medical records for medical necessity, level of care, and authorization compliance while ensuring timely appeal submissions and...
Allina HealthLos Angeles,CA
Care Management Orthopedic Navigation Program Allina Health is a not-for-profit health system that cares for individuals, families and communities throughout Minnesota and western Wisconsin. If you value putting patients first, consider a...
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...
VariteLos Angeles,CA
Job Description: Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical...
Kaiser PermanenteDowney,CA
Works collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify member needs and development of specific care...
Verisk AnalyticsLos Angeles,CA
Medical Analyst We are seeking Medical Analysts with experience in preparing Medicare Set Asides and Medical Cost Projections. This includes reviewing records, preparing the narrative and an appropriate allocation for medical treatment...
Providence Health & ServicesTorrance,CA
Nursing Assistant - Medical Surgical at Providence Little Company of Mary Torrance in Torrance, CA. This position is Full Time and will work 12-hour, Day shifts. Providence Little Company of Mary in Torrance is celebrated in 2025 as one of Americas...
ComagineLos Angeles,CA
Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We...
InSync Consulting ServicesLos Angeles,CA
Travel Registered Nurse Travel profession: RN specialty: L&D Weekly pay: $2,779 Shift details: 12-hour NOC Job order details: start date 07/06/2026, end date 10/05/2026, duration 13 weeks Client details: city...
Greenlife Healthcare StaffingLos Angeles,CA
RN Health Care Facility Surveyor - Louisiana Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting...
University of Southern CaliforniaLos Angeles,CA
In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an individual's health care needs to promote cost-effective, quality outcomes. Serves as a...
Molina HealthcareLos Angeles,CA
Job Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the...

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