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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...
CERIS HealthLos Angeles,CA
Itemization Review Nurse II The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position.
HumanaLos Angeles,CA
Care Coordinator 2 (Field Care Manager 2) Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness...
Veterans Health AdministrationLos Angeles,CA
Summary VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking a highly skilled and compassionate RN-SPHM Coordinator to join our Nursing Research, Innovation & Development Team at the Veterans in West Los Angeles. SPHM...
Sentara HealthcareLos Angeles,CA
Sentara Healthcare Integrated Nurse Case Manager Location: Manassas, VA Work Shift: First (Days) Overview: Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for Northern Virginia, VA. This is a...
Mercy HealthLos Angeles,CA
Find your calling at Mercy! Performs as an (RN) Nurse in the Mercy Virtual triage program in accordance with all applicable Federal, State, and Mercy rules, regulations, policies, and procedures, and performs all duties assigned by Medical...
Irvine Clinical ResearchLong Beach,CA
Research Nurse Healthy Brain Clinic in Long Beach is part of the Irvine Clinical Research site network, the largest of its kind on the West Coast. With 5 research centers in California, we are leaders in the search for new treatments in...
ConcentraLos Angeles,CA
PRN Remote RN Opportunity Concentra has an immediate need for an experienced and passionate PRN remote RN for our client's site in New York. This position offers an opportunity to work with a dynamic worksite and make an impact on...
Aarris HealthcareLos Angeles,CA
Per-Diem Registered Nurse (RN) Assessor - Home Care Aarris Homecare Make a Difference-On Your Schedule Aarris Homecare is a California-based, family-owned home care agency dedicated to helping seniors and adults remain safe and...
BellinLos Angeles,CA
đź’ĽJob Specifics: Location: 923 Eliza St., Green Bay, WI 54301 âť—THIS IS AN ONSITE POSITION Hours: Full-time, 0.9 FTE (36 hours per week) Work Schedule: Shifts will be a...
UnitedHealthcare At HomeLos Angeles,CA
Telehealth Urgent Care Program Sign-on Bonus up to $30,000 available for External Candidates Telephonic After-Hours Call - Evenings, Nights & Rotating Weekends Required Part-Time (20 Hours) For those who want to...
CommonSpirit HealthLos Angeles,CA
Job Summary and Responsibilities As our UM RN (Utilization Management Registered Nurse), you will be responsible for ensuring the integrity of the adverse determination processes and accuracy of clinical decision-making, as...
UnitedHealth GroupLos Angeles,CA
Nursing Facility Care Manager At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the...
University of Nebraska Medical CenterLos Angeles,CA
Requisition Details GENERAL REQUISITION INFORMATION EEO Statement: UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and...
BlueCross BlueShield of South CarolinaLos Angeles,CA
Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or...
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...
Voca HealthcareLos Angeles,CA
Voca Healthcare is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Labor and...
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...
Macpower Digital Assets EdgeLos Angeles,CA
Job Summary: The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating...
Oak St. HealthLos Angeles,CA
Utilization Management Nurse – Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and making evidence-based decisions? Join our Utilization...
CareFirst BlueCross BlueShieldLos Angeles,CA
Resp & Qualifications PURPOSE: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the...
Horizon Blue Cross Blue Shield of New JerseyLos Angeles,CA
RN Utilization Management Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care...
Scene HealthLos Angeles,CA
About Scene Health Scene is reimagining medication adherence with our 360° model of care, bringing the gold standard of Directly Observed Therapy into the digital age. Through personalized video coaching, engaging...
The START Center for Cancer ResearchLos Angeles,CA
The START Center for Cancer Research ("START") is the world's largest early phase site network, fully dedicated to oncology clinical research. Throughout our history, START has provided hope to cancer patients in global community practices by...
Keck Hospital of USCLos Angeles,CA
Details Client Name Keck Hospital of USC Job Type Travel Offering Nursing Profession Nursing Specialty...
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