Clinical Utilization Specialist

4 days ago


Beverly Hills, California, United States Emonics LLC Full time

Job Title: Clinical Utilization Specialist

About Emonics LLC:
Emonics LLC is a reputable healthcare organization that offers outpatient services. Our team consists of experienced professionals dedicated to delivering high-quality care.

Salary:$85,000 - $110,000 per year (based on experience)

About the Job:
We are seeking a skilled Registered Nurse for our utilization review team. The successful candidate will have 3 years of clinical experience in a hospital or urgent care setting and proficiency in ICD10, CPT, and HCPC coding systems. Additionally, they should be familiar with HMO, PPO, and POS plans. Preferred candidates will have managed care experience and knowledge of medical management processes and NCQA regulations.

Responsibilities:
- Conduct thorough utilization reviews to ensure patients receive necessary care
- Collaborate with healthcare providers to optimize patient outcomes
- Stay up-to-date with industry developments and best practices

Requirements:
- RN license in California
- 3 years of clinical experience in a hospital or urgent care setting
- Knowledge of ICD10, CPT, and HCPC coding systems
- Familiarity with HMO, PPO, and POS plans

Benefits:
- Competitive salary range: $85,000 - $110,000 per year
- Opportunities for professional growth and development
- Collaborative and dynamic work environment


  • Nursing Role

    2 weeks ago


    Beverly Hills, California, United States Emonics, LLC Full time

    Overview:We are seeking a skilled RN to join our team as a Utilization Review Specialist. This role is responsible for reviewing medical records and determining the necessity of treatments and services.Responsibilities:The ideal candidate will have 3 years of clinical experience in hospital or urgent care settings, with knowledge of ICD10, CPT, and HCPC...


  • Beverly Hills, California, United States Britt Medical Search Full time

    We are seeking a highly skilled and dedicated Clinical Diabetes Specialist to join our team at Britt Medical Search. The successful candidate will work closely with a team of experienced healthcare professionals to provide exceptional care to patients with diabetes in an inpatient setting.About the RoleThis is a full-time position working 4/10 hour days,...


  • Beverly Hills, California, United States CEDARS-SINAI Full time

    Clinical Pharmacist SpecialistCedars-Sinai Medical Center in Los Angeles, California is seeking a highly skilled and dedicated Clinical Pharmacist Specialist to join our Infusion Center team.The ideal candidate will possess specialized knowledge and training in specialty ambulatory infusions, prior authorization, and 340B practices as well as sterile...


  • Beverly Hills, California, United States CSMN - 1101170 - Dermatology Crisis Response Full time

    Job Title: Clinical Dermatology Nurse SpecialistOverview: CSMN - 1101170 - Dermatology Crisis Response is seeking a skilled Licensed Practical Nurse to join their team as a Clinical Dermatology Nurse Specialist.Compensation: The estimated weekly pay for this position is $1685.00, based on the job's requirements and the location in Beverly Hills, CA.About the...


  • Beverly Hills, California, United States CSMN - IM - Wil Rob Crisis Response Full time

    Nursing Opportunity in Crisis Response Setting">Clinical nurse specialist position available at CSMN - IM - Wil Rob Crisis Response. This is an excellent opportunity for an experienced LPN/LVN to join a dynamic team providing critical care services in crisis situations.Job Highlights:">Work in a fast-paced crisis response setting where no two days are the...

  • Clinical Specialist

    6 days ago


    Beverly Hills, California, United States Ascentia Staffing Full time

    About the RoleWe are seeking a highly skilled Clinical Specialist to join our team as a Travel Physical Therapist. This is an excellent opportunity for experienced professionals looking for new challenges and opportunities for growth.Job SummaryThis role requires a licensed Physical Therapist with expertise in treating patients with various conditions and...


  • Beverly Hills, California, United States Cedars-Sinai Full time

    Key ResponsibilitiesThe ideal candidate for this Clinical Support Specialist position will have two years of experience working as a Patient Service Representative in an outpatient medical office setting. Your responsibilities will include greeting patients, assisting with resolving patient issues, checking-in and out patients, collecting co-payments and...


  • Beverly Hills, California, United States MetaSense Inc Full time

    Job DescriptionClinical professionals at MetaSense Inc are responsible for delivering high-quality patient care in various healthcare settings. This role involves working as a Clinical Nurse Specialist, collaborating with medical teams to provide comprehensive patient care.The ideal candidate will possess 2+ years of telehealth experience and have prior...


  • Beverly Hills, California, United States CEDARS-SINAI Full time

    Job OverviewCedars-Sinai Medical Center is seeking a highly skilled Research Study Coordinator - Clinical Operations Specialist to join our team in the Cancer - SOCCI Clinical Research department. In this role, you will be responsible for providing study coordination, including screening of potential patients for protocol eligibility, presenting non-medical...


  • Beverly Hills, California, United States Avera Research Institute Full time

    Job OverviewThe Clinical Research Nurse Specialist at Avera Research Institute plays a vital role in providing professional nursing care to patients involved in clinical trial research studies. This position requires collaboration with the research team to ensure safe and compliant adherence to research protocols.About the RoleThis is an exciting opportunity...


  • Beverly Hills, California, United States Cedars-Sinai Full time

    About the Position: We are seeking a seasoned Clinical Pharmacy Specialist to join our Oncology team at Cedars-Sinai Medical Center. In this role, you will work closely with a multidisciplinary team of healthcare professionals to develop and implement evidence-based medication therapy plans for patients undergoing cancer treatment. Your expertise will help...


  • Beverly Hills, California, United States Beverly Hills Oncology Me Full time

    Join us at Beverly Hills Cancer Center, where we are dedicated to providing the best possible care and treatment for our patients. As a Clinical Cancer Care Specialist, you will be part of a team that is committed to excellence and innovation in oncology care. This per diem position offers flexibility and autonomy, allowing you to work on an as-needed...


  • Beverly Hills, California, United States Incredible Health Full time

    Hospitals on Incredible Health are actively hiring for a Clinical Healthcare Specialist role in Beverly, MA.Available shifts include day shift, night shift, and mid shift.Job types available: full time, part time, and per diem.Employer features: Community hospital, Cross training, EAP, FSA, Level 1 trauma center, Magnet recognized, PTO, Tuition Assistance,...


  • Beverly Hills, California, United States Medix Full time

    Job Summary:We are seeking a skilled Clinical Nurse Specialist to join our team in Beverly Hills. As an Infusion R.N, you will be responsible for administering various types of infusions, including chemotherapy agents, hydration solutions, and iron injections.About the Role:This is a full-time position working Monday through Friday, 7:30 A.M. to 4:00 P.M....


  • Beverly Hills, California, United States CEDARS-SINAI Full time

    Job OverviewCedars-Sinai, a renowned leader in healthcare, is seeking an exceptional Senior Clinical Wound Ostomy Continence Specialist to join our team. This role offers a unique opportunity to make a profound impact on patients' lives while working in a dynamic and innovative environment.About the RoleWe are looking for a skilled and compassionate...

  • Clinical Therapist

    4 weeks ago


    Beverly Hills, California, United States Optum Full time

    Optum, a clinician-led care organization, is seeking a Licensed Clinical Therapist to join our team in Beverly, MA. As a member of the Optum Behavioral Care Team, you'll play a vital role in delivering high-quality mental health services to individuals and families.About the RoleYou will treat a wide range of mental health conditions, including anxiety,...


  • Beverly Hills, California, United States TotalMed Allied Full time

    TotalMed Allied is currently seeking a highly skilled Mobile Echocardiography Specialist for a travel assignment in Massachusetts.About the JobThis is an exciting opportunity to work with a top-ranked healthcare provider as a Traveling Echo Tech.Job SummaryWe are seeking a qualified professional with experience in echocardiography to join our team for a...


  • Woodland Hills, California, United States Blue Shield of California Full time

    Job Summary:We are seeking a Chief Clinical Officer, Utilization Management to join our team at Blue Shield of California.About Us:At Blue Shield of California, we strive to be on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California.The successful candidate will report to...


  • Beverly Hills, California, United States Avera McKennan Hospital Full time

    Avera McKennan Hospital is committed to providing exceptional patient-centered nursing care. We are seeking a Medical Care Specialist to join our team in the Med Surg Unit.Job SummaryThe Medical Care Specialist will provide high-quality patient care, utilizing the nursing process to assess, plan, and implement individualized care plans. The ideal candidate...


  • Beverly Hills, California, United States Prohealth Advanced & Imag Full time

    Job OverviewAt Prohealth Advanced & Imag, we are seeking a skilled Diagnostic Imaging Specialist to join our team. This role involves performing technical procedures utilizing state-of-the-art equipment and collaborating with healthcare professionals to provide exceptional patient care.