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ADPLos Angeles,CA
iMPROve Health seeks an RN Reviewer (Workers' Compensation Utilization Review) to perform independent external medical reviews remotely as an independent contractor (1099). The reviewer applies clinical expertise to evaluate cases, ensuring...
UCLA HealthLos Angeles,CA
Patient Business Services. Provide clinical review, audit, analytical, and quality improvement support for utilization management, medical necessity determinations, and denial prevention and response efforts across the health system. As the...
Providence Health and ServicesLos Angeles,CA
Providence Home Services Oregon is seeking a Clinical Documentation Specialist, Registered Nurse (RN) for a full-time, day-shift remote role open to multiple states. You will review OASIS admission documents and Plans of Care to ensure CMS...
TEEMA GroupLos Angeles,CA
Overview TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety...
Glendale Memorial Hospital and HealthGlendale,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...
CadenceLos Angeles,CA
Cadence, the clinical AI company automating chronic disease management, is hiring an RN Manager, Alerts to lead nursing teams responsible for alert review and triage across our chronic care population. You will own staffing, scheduling, and...
Sato Service LlcLos Angeles,CA
About this role We are looking for a Patient Care Coordinator with an active LVN license and 2+ years of experience in healthcare startups to join a fast-growing surgical navigation company that's redefining how self-insured employers...
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 consideration** The Clinical...
PeratonLos Angeles,CA
Peraton's SafeGuard Services seeks a Nurse Reviewer to conduct medical record reviews, applying clinical judgment to claim payments and supporting fraud investigations. Telework is available from any state. The ideal candidate will hold a...
OptumLos Angeles,CA
Optum is seeking an Inpatient Care Management Nurse to assess and interpret member needs, guiding utilization of health services to improve outcomes. You will collaborate with clinicians, perform case reviews, and support discharge planning from...
CVS HealthLos Angeles,CA
CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely,...
PACSSouth El Monte,CA
Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude...
UnitedHealth GroupLos Angeles,CA
UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient criteria, preauthorizations, and ensuring medical necessity while applying evidence-based...
TalentBurstLos Angeles,CA
RN Clinical Documentation Integrity Specialist Remote Key Responsibilities: Ensuring Clinical Documentation Meets Quality And Regulatory Standards. Working With Medical...
LancesoftLos Angeles,CA
Overview Position Type: Full time Job Title: Care Review Clinician I Location: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH,...
University of MiamiLos Angeles,CA
Nurse Navigator 1 The University of Miami/UHealth Department of Medicine has an exciting opportunity for a Full-Time Nurse Navigator 1 to work in the UHealth Campus. Core Job Summary: The Nurse Navigator 1 (H) liaises...
Molina HealthcareLos Angeles,CA
Molina Healthcare is seeking a Remote Medical Review Nurse (RN) to work within the Central Time Zone. The role requires several years of clinical nursing experience and specific utilization review/coding expertise. You will analyze...
Saint Luke's Health SystemsLos Angeles,CA
Job Description We are hiring an RN at our Primary Care Shoal Creek location! Monday - Friday, 8am-430pm No Nights, No Weekends, No Holidays Remote opportunity every other week after 4 months MO and KS RN license required BLS required Previous...
Community Health SystemsLos Angeles,CA
Community Health Network is seeking a Remote Patient Monitoring LPN for Community ProCare at Home. This fully remote role supports patients enrolled in a remote monitoring program, reviewing transmitted data and initiating outreach according to...
FRESENIUSHarbor City,CA
STAFF RELATED:Directs Patient Care Technicians provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by...
RWJBarnabas HealthLos Angeles,CA
RWJBarnabas Health is seeking an experienced Registered Nurse for a remote, day-shift role in New Jersey. The RN will support virtual urgent care navigation, referrals, and care coordination while working with a multidisciplinary team to ensure...
California PostAcute CareLynwood,CA
Job description California Post Acute is a premier healthcare facility dedicated to providing exceptional care to our residents and patients. Our commitment to excellence, compassionate care, and innovative practices sets us apart as a...
Sutter HealthLos Angeles,CA
Mist Registered Nurse (Rn) – Position Summary The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical support to primary care patients and...
Synergy Healthcare USA, LLCLos Angeles,CA
Join to apply for the Nurse Advocate - Remote- Kansas role at Synergy Healthcare USA, LLC We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate for our new client and their employees.
Rochester Regional HealthLos Angeles,CA
Rochester Regional Health is seeking a Registered Nurse for the Communications Center (Central Triage). The role combines in-person duties at the Riedman Center with a remote option after completing an in-depth training program. Expect 40...

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