Healthcare Utilization Expert
3 days ago
As a Healthcare Utilization Expert at Enterprise Engineering, you will be responsible for reviewing patient records and providing recommendations to ensure quality, cost-effective outcomes.
This position is ideal for a UM Nurse with a passion for medical management and a desire to work remotely.
Our competitive salary is $83,000 per year, plus benefits and opportunities for professional growth.
Responsibilities- Conduct thorough medical necessity reviews using established criteria and guidelines.
- Collaborate with cross-functional teams to develop and implement care plans that meet member needs.
- Serve as a resource to non-clinical team members, providing guidance and support when needed.
- Associate's degree in nursing, preferred.
- Minimum 2 years of experience in medical management clinical functions.
- Strong working knowledge of MCG, InterQual, and NCQA standards.
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Utilization Management Expert
3 days ago
Los Angeles, California, United States Healthcare Recruitment Partners Full timeJob OverviewThis is a highly rewarding opportunity for an experienced RN to lead our Utilization Management team. As a key member of our healthcare recruitment agency, you will oversee the coordination of services through an interdisciplinary process.
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Healthcare Utilization Manager
3 weeks ago
Los Angeles, California, United States Kaiser Permanente Full timeAbout the Role">Kaiser Permanente, a leading not-for-profit health plan, seeks a skilled Healthcare Utilization Manager to join their team. This dynamic role offers an exciting opportunity to shape the future of care while making a difference in the lives of patients and communities across the nation.">Job Description">We are looking for a highly motivated...
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Healthcare Professional
5 days ago
Los Angeles, California, United States GQR Healthcare Full timeJoin GQR Healthcare's esteemed team as a skilled Nuclear Medicine professional. Key Responsibilities You will be responsible for utilizing your expertise in medical imaging to deliver high-quality patient care, working collaboratively with our team to achieve exceptional outcomes. This role offers opportunities for growth and development, allowing you to...
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Healthcare Fee Configuration Expert
5 days ago
Los Angeles, California, United States MedPOINT Management Full timeHealthcare Fee Configuration ExpertMedPOINT Management offers a competitive salary for this challenging position as a Healthcare Fee Configuration Expert. In this role, you will be responsible for creating, updating, and maintaining provider dictionaries, vendor contracts, fee schedules, reading and interpreting contracts and/or contract summaries. You will...
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Healthcare Diagnostic Expert
7 days ago
Los Angeles, California, United States GQR Healthcare Full timeNuclear Medicine Provider WantedWe're looking for an experienced Nuclear Medicine provider to join our team at GQR Healthcare. As a key member, you'll play a vital role in delivering high-quality patient care and contributing to our organization's success.Key AccountabilitiesAdminister nuclear medicine procedures to diagnose and treat patientsCollaborate...
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Healthcare AI Expert
2 weeks ago
Los Angeles, California, United States UnitedHealth Group Full timeAbout the OpportunityWe are looking for a talented Healthcare AI Expert to join our team. As a key member of our AI/ML team, you will drive the development of cutting-edge AI/ML solutions for healthcare. Your expertise in machine learning, deep learning, and NLP will enable you to design, develop, and deploy innovative solutions that improve patient...
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Healthcare Network Support Expert
5 days ago
Los Angeles, California, United States MedPOINT Management Full timeAbout the JobAs a Healthcare Network Support Expert, you will play a critical role in maintaining our network operations by responding to client IPA, provider, and provider office staff telephone inquiries. Your primary responsibility will be to provide exceptional customer service, ensuring that all necessary data is collected and completed properly,...
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Healthcare Data Integration Expert
2 weeks ago
Los Angeles, California, United States UCLA Health Full timeWhy Join Us?At UCLA Health, we are committed to delivering exceptional patient care and advancing healthcare research. As a Healthcare Data Integration Expert, you will have the opportunity to make a meaningful impact on our operations and contribute to our mission.Key ResponsibilitiesMaintaining and running processes for electronic claims and other EDI...
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Healthcare Revenue Cycle Expert
3 days ago
Los Angeles, California, United States Center for Family Health and Education Full timeJob SummaryWe are seeking a highly skilled Healthcare Revenue Cycle Expert to join our team at the Center for Family Health and Education, Inc. (CFHE).About the Role:This position is responsible for overseeing the revenue cycle process, ensuring accurate and timely claims submission, and maintaining compliance with regulatory requirements.The successful...
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NICU Manager
3 weeks ago
Los Angeles, California, United States GQR Healthcare Full timeGQR Healthcare is seeking a highly skilled NICU Manager to join our team. As a seasoned healthcare professional, you will be responsible for overseeing the day-to-day operations of our Neonatal Intensive Care unit.About the RoleSupervise and manage a team of 25 direct reportsFloating across departments as needed to ensure seamless care deliveryParticipate in...
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Healthcare Nutrition Expert
7 days ago
Los Angeles, California, United States Healthcare Staffing Professionals, Inc Full timeAbout the Role:This is an excellent opportunity for a Dietitian Specialist to provide high-quality nutrition services in a fast-paced healthcare environment.
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Food Service Utility Specialist
4 weeks ago
Los Angeles, California, United States Morrison Healthcare Full timeEstablished in 1957, Morrison Healthcare is a leading provider of food and nutrition services to more than 806 hospitals and healthcare systems across the United States.Morrison's mission is to create personalized dining experiences for patients and staff while advancing the healing and healthful missions of its clients. Our team of experienced chefs,...
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Senior Utilization Management Director
4 weeks ago
Los Angeles, California, United States Healthcare Recruitment Partners Full timeJob Title: Senior Utilization Management DirectorAbout the Role:We are seeking a seasoned RN Manager of Utilization Management to join our team at Healthcare Recruitment Partners in West Los Angeles, California.Responsibilities:Oversee day-to-day operations, including staff schedules, assignments, and caseloads to ensure optimal hospital-wide...
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Medicaid Policy Expert
3 days ago
Los Angeles, California, United States pro it Full timeAbout Our CompanyAt pro it, we believe in providing innovative solutions to improve the lives of millions. As a leading provider of case management services, we strive to make a difference in the communities we serve.Job DescriptionWe are seeking a highly knowledgeable and experienced professional to join our team as a Medicaid Subject Matter Expert. This...
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Expert Case Management Travel Nurse
7 days ago
Los Angeles, California, United States GQR Healthcare Full timeGQR Healthcare is a leading healthcare staffing agency with a focus on connecting experts in the industry to highly skilled healthcare professionals across the US market.With years of experience in talent acquisition, we deliver continuity of care for the communities our partners serve, ensuring the patient experience is of the highest quality.We specialize...
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Mixology Expert
5 days ago
Los Angeles, California, United States Living Room LA Full timeAbout the RoleAt Living Room LA, we are seeking a skilled Mixology Expert to join our team. As a key member of our beverage program, you will be responsible for crafting exceptional cocktails and providing top-notch service to our members and guests.Job ResponsibilitiesPrepare and serve a variety of beverages, including craft cocktails and other drinksGreet...
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Ceremonial Waxing Expert
4 days ago
Los Angeles, California, United States European Wax Center Full timeAs a Senior Esthetician at European Wax Center, you will be part of a dynamic team that offers exceptional waxing services. Our ideal candidate is goal-oriented, accountable, and has excellent communication skills. You will join a team of expert Estheticians, utilize innovative products and services, and experience state-of-the-art technology.We strive to...
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Travel Healthcare Specialist
5 days ago
Los Angeles, California, United States TotalMed Staffing Full timeAbout TotalMed Staffing:We provide flexible staffing solutions that cater to the unique needs of our clients. Our team of recruitment experts works tirelessly to ensure that our candidates are matched with the best opportunities available.Job Summary:We are currently seeking a skilled Utilization Review Registered Nurse for a Travel Nursing position in Los...
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Utilization Management Director
3 days ago
Los Angeles, California, United States Healthcare Recruitment Partners Full timeJob OverviewThe Utilization Management Director balances individual patient and family needs with cost-effective utilization of resources. This role requires strong leadership skills and the ability to collaborate with an interdisciplinary team.Key Responsibilities:Assesses patients to determine the appropriateness of their level of care.Develops and...
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Medical Social Worker
7 days ago
Los Angeles, California, United States MLK Community Healthcare Full timeJob OverviewWe are seeking a highly skilled and compassionate Medical Social Worker to join our team at MLK Community Healthcare. This is a per diem, night shift position working in the emergency room setting.