Utilization Review Jobs in Los Angeles
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Search Results - Utilization Review Jobs in Los Angeles
Medical Solutions-Glendale (CA), 14 mi from Los Angeles
Job Description
Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Glendale, California.
Job Description & Requirements
• Specialty: Utilization Review
• Discipline: RN
• Duration: 13 weeks...
Macpower Digital Assets Edge Private Limited-Los Angeles
Health Plan guidelines and patient needs.
Assures compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements.
Provides direction to staff regarding utilization review, care coordination, discharge...
resume-library.com -
Providence-Mission Hills (CA), 24 mi from Los Angeles
Description
Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans.
This role requires...
Diverse Lynx-Torrance, 11 mi from Los Angeles
All RTO submitted upfront
There is an every third weekend rotation required.
Must work PST hours
This is M-F unless the candidate is scheduled for the weekend. Then their weekday shifts will be modified to allow for the weekend shifts. Candidates...
resume-library.com -
Lynwood (CA), 3 mi from Los Angeles
review of the medical record for the medical necessity, intensity of service and severity of illness.
Qualifications:
EDUCATION, EXPERIENCE, TRAINING
1. Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school...
icims.com -
Diverse Lynx-Beverly Hills (CA), 11 mi from Los Angeles
This position will travel to multiple clinics for incident management and staff training
This position will be supervised and receive assignments from a remote RN
Mileage reimbursement provided
Schedule: Monday-Friday
Shift:...
resume-library.com -
Medical Solutions-Glendale (CA), 14 mi from Los Angeles
Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Glendale, California.
Job Description & Requirements
• Specialty: Utilization Review
• Discipline: RN
• Duration: 13 weeks
• 40 hours per...
Macpower Digital Assets Edge Private Limited-Los Angeles
JOB OVERVIEW: As the Director of Case Management, you will be the cornerstone of our efforts to deliver high-quality, cost-effective healthcare services. You'll lead initiatives in utilization review, discharge planning, and care coordination across...
resume-library.com -
L.A. Care Health Plan-Los Angeles
and tools while also performing utilization review of cases.
The Medical Director reports to the Senior Medical Director, Community Health. This position works closely with our Community Platform team as well as with other cross-functional teams within L.A...
appcast.io -
Molina Healthcare-Los Angeles
Education
Bachelor's Degree in Nursing
Preferred Experience
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
Effective verbal and written...
Northeast Healthcare Recruitment, Inc. (NEHCR)-Cerritos (CA), 12 mi from Los Angeles
healthcare quality, cost, and outcomes.
7. Identify and develop innovative opportunities to enhance effectiveness and quality.
8. Full Time, Call 1:4
9. 100% Virtual
10. Apply Criteria, Utilization review
Requirements:
1. MD or DO with Board certification...
appcast.io -
Alameda Health System-Los Angeles
Summary
Role Overview:
The System Educator of Care Coordination and Utilization Review is responsible for developing, implementing, and maintaining education and training programs across the organizations care coordination and utilization...
tiptopjob.com -
Expert In Recruitment Solutions-Glendale (CA), 14 mi from Los Angeles
change is possible within existing system.
This Systems Analyst contractor position is part of the HHSC Managed Care Utilization Review team and will develop a customized solution in the HHS Microsoft 365 Power Platform for the modernization...
resume-library.com -
Molina Healthcare-Los Angeles
with reliable transportation.
State Specific Requirements:
Must be licensed for CALIFORNIA
Preferred Experience
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG...
Optum-Los Angeles
management, home health, discharge planning, utilization review, patient education and telephonic nursing
Preferred Qualifications:
• Bachelor of Science in Nursing
• American Academy of Ambulatory Care Nursing (AAACN)
• 1+ years of Call Center Nursing...
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