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Infirmary HealthLos Angeles,CA
Responsibilities Plans, implements, coordinates, and evaluates comprehensive care for designated patients to ensure quality of care and continuity of care delivery through telehealth platforms. QualificationsMinimum...
Kaiser PermanenteDowney,CA
Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance consistent...
American Health PlansLos Angeles,CA
American Health Plans Franklin, TN 37067, USA Description American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for...
University of Chicago MedicineLos Angeles,CA
UChicago Medicine in Chicago, IL is seeking a Clinical Documentation Nurse - Quality to join the Office of External Assessments. This role primarily offers remote work from home, with residency in Chicagoland required, and focuses on accurate...
DreamboundMontrose,CA
Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the...
Allina HealthLos Angeles,CA
Allina Health is seeking a Nurse Informaticist to join the Information Systems Optimization Solutions team. The role focuses on integrating nursing practice with data science to improve patient outcomes and care quality across inpatient and...
UCSF Health Medical FoundationLos Angeles,CA
UCSF Health Medical Foundation is seeking an experienced Primary Care Telephone Triage Registered Nurse to work remotely from home. The role requires a California RN license, at least two years of full-time triage or acute care RN experience, and...
ExamworksLos Angeles,CA
ExamWorks is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator. This 100% remote role focuses on QA of peer review reports, ensuring accuracy, clinical citations, and adherence to client specifications and...
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...
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,...
Charter GlobalLos Angeles,CA
Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...
TalantirLos Angeles,CA
Essential Duties and Responsibilities: Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. Issue...
Opus MedicalLos Angeles,CA
Opus Medical is seeking a Nurse Liaison to coordinate care and communicate crucial medical information in the United States, specifically in Pensacola, Florida. This remote role involves responsibilities like managing case plans, building...
OPCO Skilled ManagementLos Angeles,CA
OPCO Skilled Management is seeking a Central Intake Nurse for a remote, full-time role. You will collect referral documentation from physicians, insurers, and providers to determine service appropriateness and coordinate patient care plans with...
Crossing HurdlesLos Angeles,CA
Position: Clinical Professionals: Paid Study on Healthcare Software Workflows Type: Hourly Contract Compensation: $60/hr Location: Remote Role Responsibilities Navigate a...
NTT GroupLos Angeles,CA
NTT DATA is seeking a BPO Clinical Review Specialist in the United States, with remote work available for Florida residents. The role requires an active RN license (Florida or Compact) and at least 3 years of appeals, utilization management, or...
IQVIALos Angeles,CA
IQVIA is seeking a Flex Nurse Educator to deliver remote patient education and in-field support during territory vacancies, supporting adherence and disease management. This is a non-clinical, educational role requiring an active RN...
EffizotechLos Angeles,CA
Effizotech is looking for a dedicated Patient Care Coordinator to join their team. This role involves coordinating patient appointments for infusion services while ensuring timely communication with patients. The opportunity offers the flexibility...
University of Minnesota School of NursingLos Angeles,CA
UnitedHealth Group is seeking a SSBV Clinical Claims Review RN for a remote role nationwide. You will perform administrative reviews of inpatient hospital claims, document determinations, and ensure accurate use of screening criteria to support...
OptumLos Angeles,CA
Optum is seeking a registered nurse in Hawaii to assess needs, interpret requirements, and identify solutions while working with minimal guidance. You will interpret clinical documentation, support care decisions, and coach peers as an expert...
Amerit ConsultingLos Angeles,CA
Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...
GQR HealthcareDowney,CA
GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty:...
START ResearchLos Angeles,CA
START Research's START Center for Cancer Research in Los Angeles is seeking a Clinical Research Coordinator, RN to support early-phase oncology trials. The role involves direct patient interaction, data collection, and ensuring protocol compliance...
CVS HealthLos Angeles,CA
CVS Health is seeking a Utilization Management Nurse Consultant (Medical Review) to ensure members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote role leverages your...
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.

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