Clinical Utilization Specialist
3 weeks ago
In this challenging role, you will play a crucial part in ensuring our members receive the necessary healthcare services. As a Utilization Management Nurse Specialist RN II, you will facilitate and coordinate medically necessary referrals, ensuring timely and accurate determinations. You will also generate approval, modification, and denial communications to stakeholders.
This position requires strong communication and problem-solving skills, as well as the ability to work effectively in a fast-paced environment. If you are a skilled nurse with experience in utilization management or case management, we encourage you to apply.
- Estimated Salary Range: $88,854 - $142,166 per year
- Location: Los Angeles, CA
- Requisition ID: 11812
-
Clinical Utilization Management Specialist
17 hours ago
Los Angeles, California, United States MLK Community Healthcare Full timeOverviewThe Utilization Management Physician Advisor role at MLK Community Healthcare involves acting as a liaison between hospital administration, clinical staff, and support personnel. This part-time position requires regular interaction with the Senior Director of Care Management, care management staff, and healthcare team members to discuss selected...
-
Clinical Research Medical Assistant Specialist
3 weeks ago
Los Angeles, California, United States Matrix Clinical Research Full timeJob OverviewMatrix Clinical Research is a leading organization in the field of clinical research, dedicated to advancing medical knowledge and improving patient outcomes. We conduct cutting-edge research studies in various therapeutic areas, and we are seeking a skilled Clinical Research Medical Assistant Specialist to join our dynamic team.
-
Private Utility Specialist
3 weeks ago
Los Angeles, California, United States USIC Full timeJob Details:We are seeking a skilled Private Utility Specialist to join our team at USIC. As a key member of our crew, you will be responsible for providing utility locating services while building the business.Salary: $28-$30/hour + monthly bonusResponsibilities:Identify, locate, and mark all utilities within a requested job scopeManage sales cycle to close...
-
Medical Management Specialist
1 month ago
Los Angeles, California, United States E-talentnetwork Full timeJob Summary: We are seeking a highly skilled Medical Management Specialist to join our team at E-talentnetwork. This role is responsible for ensuring appropriate, cost-effective, and high-quality care for patients.About the Role:This position involves conducting utilization management activities in accordance with health plan policies and regulatory...
-
Clinical Utilization Specialist
2 weeks ago
Los Angeles, California, United States Acentra Health Full timeJob DescriptionAcentra Health is seeking a skilled Clinical Reviewer to join our team in California.This is a full-time remote position requiring residence and active licensure in California, offering you an opportunity to make a meaningful impact without direct patient contact.A current California LCSW, LMFT, LPCC, or LCPC license is required. Candidates...
-
Los Angeles, California, United States Macpower Digital Assets Edge Full timeRole Summary:We are seeking an experienced Registered Nurse (RN) to join our team as a Utilization Management Policy Initiatives Specialist. The successful candidate will have at least 8 years of previous experience in Clinical Nursing and a strong background in performing and creating clinical documentation.The ideal candidate will be responsible for...
-
Utilization Management Clinical Leader
3 weeks ago
Los Angeles, California, United States Scout Exchange Full timeKey Responsibilities:As a Utilization Management Clinical Leader at Scout Exchange, you will be responsible for the following key responsibilities:* Reviewing and evaluating existing healthcare services clinical policies* Proposing recommendations to improve existing clinical policies* Collaborating with certified coders to develop and ensure proper clinical...
-
Experienced Utility Coordinator
3 weeks ago
Los Angeles, California, United States Dabri, Inc Full timeAbout the RoleWe are seeking a seasoned Utility Coordinator to join our team at Dabri, Inc. as a Project Delivery Specialist. This role is a key position in supporting the Advanced Transportation Management Program (ATMP) for Transportation/Roadway projects at the Los Angeles World Airports (LAWA).The ideal candidate will possess extensive experience in...
-
Healthcare Utilization Specialist Day Shift
5 days ago
Los Angeles, California, United States Kaiser Permanente Full time**About the Position:**We are seeking an experienced Utilization Management Specialist to join our team at Kaiser Permanente. As a Utilization Management Specialist, you will play a key role in ensuring that our patients receive the most effective care possible while minimizing unnecessary costs.Responsibilities:**Work collaboratively with physicians and...
-
Outpatient Utilization Manager
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob Summary: We are seeking a detail-oriented and organized Clinical Coordination Specialist to join our team at MedPOINT Management. In this role, you will be responsible for coordinating clinical activities, communicating with healthcare providers, and maintaining accurate records of patient information.About the Role:The Clinical Coordination Specialist...
-
Clinical Specialist
4 weeks ago
Los Angeles, California, United States 365 Healthcare Staffing Services, Inc. Full timeJob Overview:We are seeking an experienced Registered Nurse to join our team as a Clinical Specialist at 365 Healthcare Staffing Services, Inc. In this role, you will work closely with patients and healthcare staff in various settings, providing expert guidance and support to ensure optimal patient outcomes.About the Position:The ideal candidate will have at...
-
Clinical Research Coordinator Specialist
3 weeks ago
Los Angeles, California, United States Matrix Clinical Research Full timeWe are seeking a motivated and detail-oriented Research Coordinator to join Matrix Clinical Research. The estimated salary for this role is $60,000 - $80,000 per year.Job DescriptionThe Research Coordinator will play a critical role in supporting our research projects by managing the daily operations, coordinating between different stakeholders, and ensuring...
-
Clinical Care Specialist
3 weeks ago
Los Angeles, California, United States Wellpsyche Full timeJob Title: Clinical Care SpecialistAre you a compassionate and skilled Psychiatric Nurse Practitioner looking to make a difference in the lives of your patients? We are seeking a highly motivated and experienced clinician to join our team as a Clinical Care Specialist.**Company Overview:**WellPsyche Medical Group is a physician-run leader in Telepsychiatry,...
-
Utilization Management Nurse Specialist
3 weeks ago
Los Angeles, California, United States Presidential Staffing Solutions, LLC Full timeJob SummaryWe are seeking a highly skilled Utilization Management Nurse to join our team at Presidential Staffing Solutions, LLC. As a key member of our team, you will play a crucial role in reviewing patient files and treatment methods to ensure optimal efficiency and effectiveness.Your primary responsibility will be to monitor the activity of staff,...
-
Clinical Leadership Specialist
3 weeks ago
Los Angeles, California, United States SCHARP California Full timeJob Title$85,000 - $105,000 per yearWe are seeking a highly experienced and passionate individual to join our team as a Clinical Leadership Specialist at SCHARP California. As a key member of our leadership team, you will oversee the mental health services provided to vulnerable populations in South Los Angeles.About the RoleProvide oversight for assigned...
-
Clinical Documentation Specialist
3 weeks ago
Los Angeles, California, United States Dynamic Nursing, Inc. Full timeJob SummaryWe are seeking a Clinical Documentation Specialist to join our team at Dynamic Nursing Inc. in Sherman Oaks, CA.About the Role:Transcribe medical reports from field nurses in patients' homesUtilize computer software to quickly and efficiently transcribe reportsReview reports for completeness and accuracyCorrect errors in transcription, grammar,...
-
Utilization Management Policy Specialist RN
1 month ago
Los Angeles, California, United States Scout Exchange Full timeJob Summary: We are seeking a highly skilled Utilization Management Policy Initiatives Nurse II to join our team at Scout Exchange. As a key member of our Utilization Management Department, you will be responsible for managing, reviewing, updating and creating Healthcare Services clinical policies, guidelines, protocols and related documentation.About the...
-
Clinical Practice Specialist
3 days ago
Los Angeles, California, United States Headway Full timeAbout HeadwayHeadway is a leading provider of mental health services, dedicated to revolutionizing the industry with innovative solutions.Your RoleWe are seeking a skilled Clinical Practice Specialist to join our team. As a licensed Clinical Social Worker (LCSW), you will be responsible for providing high-quality care to patients while leveraging our...
-
Utility Coordination Specialist
3 weeks ago
Los Angeles, California, United States P5 Consulting Services Full timeSenior Utility Coordinator Job DescriptionP5 Consulting Services is seeking a talented Senior Utility Coordinator to join our team. As a Senior Utility Coordinator, you will play a critical role in ensuring the successful execution of infrastructure projects.You will work closely with project managers, clients, and utility owners to resolve utility conflicts...
-
Housing Utilization Manager
17 hours ago
Los Angeles, California, United States Brilliant Corners Full timeJob OverviewBrilliant Corners is a leading provider of innovative housing solutions, dedicated to serving California's most vulnerable individuals. We are seeking an exceptional Housing Utilization Supervisor to join our team.ResponsibilitiesLead a team of Occupancy Specialists in maintaining unit listing websites and facilitating the unit matching...