Current jobs related to Utilization Review RN - Mission Hills - Providence Service
-
Utilization Review RN Per Diem/Days
1 week ago
Mission Hills, United States Providence Full timeDescription 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 a strong clinical background combined with well-developed knowledge and skills in Utilization Management,...
-
Director, Commercial Utilization Management
1 month ago
Woodland Hills, United States Blue Shield of CA Full timeYour Role Reporting to the Sr. Director, Utilization Management, the role of the Director, Commercial Utilization Management is critical to the success of Blue Shield of California and the Utilization Management department in realizing its goals and objectives. This individual will play a key role as part of Utilization Management team in delivering and...
-
QC Data Reviewer
3 days ago
Vernon Hills, Illinois, United States Actalent Full timeJob Summary:Data ReviewerJob DescriptionRoutinely communicate with various individuals or groups on data review, corrections, issues, and solutions. Ensure documentation of experiments are in accordance with company policies and procedures. Work collaboratively with Quality Assurance staff to develop procedures that support quality activities.Key...
-
Senior Utilization Management Nurse
3 days ago
El Dorado Hills, California, United States Blue Shield of CA Full timeYour RoleThe Utilization Management team reviews inpatient stays for our members under nationally recognized levels of care guidelines.This role reports to the Utilization Management Nurse Manager.As a Senior Utilization Management Nurse, you will be assigned a list of inpatient facilities and review clinical information provided by the facilities to...
-
Travel Nurse RN Case Manager
3 days ago
Mission Hills, Kansas, United States Cross Country Nurses Full timeJob Title: Travel Nurse RN Case ManagerJob Description:Cross Country Nurses is seeking a travel nurse RN Case Management professional to collaborate with the healthcare team to assess, plan, facilitate and coordinate care for individual patients. This role involves overseeing the effective utilization of services and resources, communicating with patients,...
-
QC Data Review Specialist
1 week ago
Vernon Hills, Illinois, United States Actalent Full timeJob DescriptionRoutinely communicate with various individuals or groups on data review, corrections, issues, and solutions. Ensure documentation of experiments are in accordance with company policies and procedures. Work collaboratively with Quality Assurance staff to develop procedures that support quality activities. Assist in quality assurance processes...
-
Travel Nurse RN Case Management Position
7 days ago
Mission Hills, Kansas, United States Cross Country Nurses Full timeCross Country Nurses is seeking a travel nurse RN Case Management professional to collaborate with the healthcare team in providing high-quality patient care.Job DescriptionAs a case management nurse (RN CM), you will be responsible for assessing, planning, facilitating, and coordinating care for individual patients. You will work closely with the healthcare...
-
Senior Utilization Management Nurse
3 days ago
Woodland Hills, Utah, United States Blue Shield of CA Full timeYour RoleThe Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events.In this role, you will be reviewing medical documents and applying clinical criteria to establish the most appropriate level of care.You will also be...
-
Mission Hills, United States Aureus Group Full timeNICU Registered Nurse- 13 weeks needed in CA for a travel assignment. Contact Aureus today to inquire and apply! Position: RN Specialty/Modality: RN-Neonatal ICU Licenses/Certifications: CPR/BLS (Basic Life Support), State License-RN-California, NRP (Neonatal Resuscitation Prog/NALS) Physical Abilities: From 50-100lbs Travel the country while you enhance...
-
Travel Nurse RN Specialist
2 weeks ago
Mission Hills, Kansas, United States Cross Country Nurses Full timeCross Country Nurses is seeking a skilled travel nurse RN for an exciting opportunity in Emergency Department.As an emergency room nurse, you will be the first line of defense for patients who require urgent medical care. You will treat patients who are suffering from trauma, injury, or severe medical conditions.Key Responsibilities:Assess patient condition...
-
Mission Hills, United States NuWest Travel Nursing Full timeNuWest Travel Nursing is seeking a travel nurse RN for a NICU position in Mission Hills, California.Job DetailsSpecialty: NICUDiscipline: RNEmployment Type: TravelThis travel nursing job offers 36 hours per week for 12 weeks in Mission Hills, California.Vivian Health provides transparent travel nursing salary information and unbiased reviews from leading...
-
Travel Nurse RN Position in NICU
6 days ago
Mission Hills, United States NuWest Travel Nursing Full timeNuWest Travel Nursing is seeking a travel nurse RN for a NICU - Neonatal Intensive Care position in California.Job DetailsSpecialty: NICU - Neonatal Intensive CareDiscipline: RNEmployment Type: TravelVivian Health provides transparent travel nursing salary information and unbiased reviews from leading travel nurse agencies across the United States.With...
-
Mission Hills, California, United States Cross Country Nurses Full timeCross Country Nurses is seeking a travel nurse RN Case Manager for a travel nursing position in a California facility.Specialty: Case Management ~ Shift: 8 hours, days ~ Employment Type: Travel As a case management nurse (RN CM), you will collaborate with the healthcare team to assess, plan, facilitate and coordinate care for individual patients. Working...
-
Travel Nurse RN Position
3 days ago
Mission Hills, California, United States LanceSoft Full timeLanceSoft is seeking a travel nurse RN for a NICU - Neonatal Intensive Care position in Mission Hills, California.Job DetailsSpecialty: NICU - Neonatal Intensive CareDiscipline: RNEmployment Type: TravelThis travel nursing job includes 36 hours a week for 13 weeks in Mission Hills, California.Vivian Health provides transparent travel nursing salary...
-
Mission Hills, California, United States Cross Country Nurses Full timeCross Country Nurses is seeking a travel nurse RN Case Manager to collaborate with the healthcare team in assessing, planning, facilitating, and coordinating care for individual patients.Key Responsibilities: Oversee the effective utilization of services and resources within and outside of facilities.Communicate with patients, families, other healthcare...
-
Clinical Quality Review Manager
2 weeks ago
El Dorado Hills, California, United States Blue Shield of CA Full timeAbout the RoleWe are seeking a highly skilled and experienced Clinical Quality Review Manager to join our team at Blue Shield of California. As a key member of our Clinical Quality Review team, you will play a critical role in ensuring the highest quality of care for our members.Key ResponsibilitiesProvide strategic leadership and oversight to the Clinical...
-
Travel Nurse RN Position in NICU
3 days ago
Mission Hills, Kansas, United States GHR Healthcare Full timeGHR Healthcare is seeking a travel nurse RN for a NICU - Neonatal Intensive Care position in California.Job DetailsSpecialty: NICU - Neonatal Intensive CareDiscipline: RNDuration: 13 weeksHours: 36 hours per weekShift: 12 hours, nightsGHR Healthcare is a leading healthcare staffing agency with over 30 years of experience. We are committed to providing our...
-
Travel Nurse RN
3 days ago
Mission Hills, United States Access Health Care Physicians LLC Full timeAccess Healthcare is seeking a travel nurse RN for a NICU position in California. Job Details Specialty: NICU - Neonatal Intensive CareDiscipline: RNEmployment Type: TravelVivian Health provides transparent travel nursing salary information and unbiased reviews from leading travel nurse agencies across the United States, so you can compare travel...
-
Travel Nurse RN
7 days ago
Mission Hills, United States Access Health Care Physicians LLC Full timeAccess Healthcare is seeking a travel nurse RN NICU - Neonatal Intensive Care for a travel nursing job in a top-ranked hospital. Job Details Specialty: NICU - Neonatal Intensive Care Discipline: RN Shift: 12 hours, nights Employment Type: Travel Access Healthcare is a leading healthcare staffing agency providing top-notch travel nursing opportunities. We are...
-
Emergency Department Nurse
3 days ago
Mission Hills, Kansas, United States Cross Country Nurses Full timeCross Country Nurses is seeking a travel nurse for an emergency department assignment. The ideal candidate will have at least 1 year of recent acute care experience in the specialty and an active RN license.Job DescriptionAs an emergency room nurse, you will be responsible for providing care to patients who require urgent medical attention. You will assess...
Utilization Review RN
2 months ago
Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required qualifications: Nursing school graduate. California Registered Nurse License upon hire 3 years of experience in utilization management and/or case management. 3 years of clinical experience in hospital or medical office/clinic setting. Experience with Milliman criteria. Preferred qualifications: Bachelor’s Degree in Nursing or related field. Certification in Case Management (CCM) upon hire Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. About the Team Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers. PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 307917 Company: Providence Jobs Job Category: Health Information Management Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Nursing Department: 7520 UTIL MGMT CA HERITAGE Address: CA Mission Hills 15451 San Fernando Mission Blv Work Location: Facey Medical Foundation Admin Office-Mission Hills Pay Range: $52.46 - $83.05 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.