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University of Southern CaliforniaGlendale,CA
Responsible for admissions, concurrent and/or retrospective reviews of all patients in accordance with the criteria, policies, and procedures approved by the Performance Improvement Committee, and consistent with Federal and State guidelines, PRO...
Sutter HealthLos Angeles,CA
We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone...
Legacy HealthLos Angeles,CA
Overview The Legacy/OHSU Interventional Radiology practice provides services at four locations (EMC, GSMC, MHMC and MPMC) including ambulatory clinics at each site. The IR team cares for both adult and pediatric patients with...
ResPro HealthLos Angeles,CA
ResPro Health is dedicated to providing our partners in the respiratory space with the tools and resources needed to implement meaningful programs like remote patient monitoring and chronic care management in their pulmonary practices. With a...
UnitedHealthcare At HomeLos Angeles,CA
Clinical Appeals 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 people with the...
NPHireLos Angeles,CA
Work From Home Nurse Practitioner – Telehealth Women's Health | $125K+2 days ago Be among the first 25 applicantsThis range is provided by NPHire. Your actual pay will be based on your skills and experience — talk with your recruiter to learn...
St. Louis County (MO)Los Angeles,CA
Salary: See Position Description Location : North Central Community Health Center - St Louis County, MO, MO Job Type: Full-Time Remote Employment: Flexible/Hybrid...
Blue Cross and Blue Shield of Kansas CityLos Angeles,CA
Job Title Utilizes a collaborative review process of benefits, minimally necessary clinical information and evidence-based clinical guidelines to formulate decisions regarding medical necessity, pre-existing conditions, benefits and/or...
Parkview HealthLos Angeles,CA
Summary *This position is located in Fort Wayne, Indiana it is is NOT a remote role. Summary Independently plans and provides excellent professional nursing care for patients in accordance with...
Equum MedicalLos Angeles,CA
Join Equum Medical and be a driving force in revolutionizing acute care telehealth. As an innovative leader in the healthcare technology industry, Equum Medical is dedicated to transforming how patients access critical medical services.
Mass General BrighamLos Angeles,CA
Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit,...
Elevance HealthLos Angeles,CA
Anticipated End Date: 2026-07-01 Position Title: Nurse Appeals-RN (California) Job Description: Nurse Appeals RN Locations: Woodland Hills, CA and Costa Mesa, CA ...
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...
divvyDOSELos 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...
Amerit ConsultingLos Angeles,CA
Overview:Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Appeals and Grievance RN .*** Candidate must be authorized to work in USA without requiring sponsorship...
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...
Cedar Sinai TACRI ImagingLos Angeles,CA
Details Client Name Cedar Sinai TACRI Imaging Job Type Travel Offering Nursing Profession RN Specialty...
ATC West HealthcareDowney,CA
ATC WEST HEALTHCARE IS CURRENTLY HIRING FOR AN RN CLINIC ASSIGNMENT FOR A PROMINENT HEALTHCARE FACILITY IN DOWNEY- CA, USA. INTERESTED? CALL OR TEXT JOE [Click to See Phone] ASSIGNMENT DETAILS FOR AN RN CORRECTION: • Work...
Providence ServiceLos Angeles,CA
Description RN Utilization Review - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA...
LancesoftLos Angeles,CA
OverviewPosition Type: Full timeJob Title: Care Review Clinician ILocation: 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, TX, UT, WA (outside greater-Seattle),...
StaffDNALos Angeles,CA
Tele Travel RN Job Type: Travel Profession: RN Specialty: Tele Shift Details: Week 1 Shift 12H Nights Week 2 Shift 4x12 Nights Job Order Details: Start Date 05/04/2026 End Date 08/01/2026 Duration 13 Week(s)...
AmergisLos Angeles,CA
Remote - Candidate is required to reside in California. The RN School Support Manager is responsible for the clinical oversight of the designated medical care needs per the district contract. This oversight includes support of care...
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...
PIH HealthLos Angeles,CA
The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nations top hospital systems for best...
Trinity HealthLos Angeles,CA
Employment Type: Full time Shift: Day Shift Description: Purpose Work Remote Position (Pay Range: $36.8795-$47.8193) The Nursing...
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