Utilization Management Nurse Specialist

Job OverviewPosition: Outpatient Utilization Management Specialist at MedPOINT ManagementRole SummaryThe Outpatient Utilization Management Specialist is essential in enhancing communication between Managed Services Organizations (MSO), Independent Physician Associations (IPA), and members to guarantee seamless member care. Key responsibilities include...

Job SummaryWe are seeking a highly skilled Utilization Management Nurse to join our team at Presidential Staffing Solutions, LLC. As a Utilization Management Nurse, you will play a critical role in ensuring the efficient and effective delivery of patient care.Key ResponsibilitiesReview patient files and treatment information to identify opportunities for...

Salary Range: $88, Min.) - $115, Mid.) - $142, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get...

Job OverviewThe Outpatient Utilization Management Coordinator serves as the primary liaison between the Outpatient Utilization Management (UM) team and Health Plan representatives. This position is responsible for managing referral requests directed to Health Plans, including but not limited to tertiary care, durable medical equipment, and pharmacy services,...

Position OverviewAt Cedars-Sinai, we understand that the work we do has a profound effect on the well-being of individuals. Our commitment to excellence is reflected in our six consecutive Magnet designations for nursing quality. By joining our team of distinguished healthcare professionals and utilizing cutting-edge facilities, you will have the opportunity...

Job Overview At Cedars-Sinai, the work you engage in daily significantly influences the well-being of others. Every effort, detail, and moment counts. This culture of commitment and enthusiasm is part of what has earned us six consecutive Magnet designations for nursing excellence. Collaborating with a team of leading healthcare professionals and utilizing...

Specialty: Travel RN - Utilization ManagementPosition OverviewEngage and collaborate with healthcare professionals to evaluate, plan, implement, and review patient care strategies. Communicate with physicians to rectify inaccuracies or omissions and to probe into questionable claims. Deliver direct nursing services to patients and analyze medical...

Specialty: Travel RN - Utilization ManagementPosition OverviewAs a key member of the healthcare team, you will engage in consulting and coordinating with various healthcare professionals to assess, plan, implement, and evaluate comprehensive patient care strategies. Your role will involve communicating with physicians to rectify any discrepancies or...

Job OverviewAt Cedars-Sinai, the work you perform daily significantly influences the well-being of individuals. Every detail and moment is vital. Our culture of commitment and enthusiasm is one of the many reasons we have earned the prestigious Magnet designation for nursing excellence six times in a row. You will collaborate with a team of top-tier...

Job OverviewSubzero Excavating, a leading contractor in the Underground Utilities sector, is seeking a dedicated Underground Utilities Installation Specialist. This role focuses on the excavation and installation of essential utility systems, including both wet and dry utilities.Key Responsibilities:Assemble and install comprehensive plumbing...

Job OverviewAt Cedars-Sinai, the work you do is vital to the well-being of countless individuals. Our commitment to excellence and patient care is reflected in our six consecutive Magnet designations for nursing excellence. Here, you will collaborate with a team of leading healthcare professionals and utilize advanced facilities to make a significant impact...

Position OverviewThe Clinical Utilization Management Advisor (CUMA) serves as a vital link among hospital administration, clinical personnel, and support teams. This role encompasses part-time inpatient duties in utilization management and care coordination while also maintaining a portion of inpatient patient care responsibilities. The expectation is for...

Job Title: Travel Nurse ICU SpecialistJob Type: Travel NursingLocation: Los Angeles, CaliforniaJob Description:Job Summary:Nurse First is seeking a highly skilled and experienced Travel Nurse ICU Specialist to join our team. As a Travel Nurse ICU Specialist, you will be responsible for providing high-quality patient care in a fast-paced Intensive Care Unit...

Manager, Utilization Management Location: Los Angeles, CA, US Compensation: $165,000 - $175,000 + Bonus + SIGNING BONUS + Paid Relocation *RN Required* On-Call Rotation Required The Manager of Utilization Management oversees the daily functions of the Utilization Management Program within the designated Service Area or Medical Center. This role is pivotal in...

Job DescriptionCompany: MedPOINT ManagementPosition: Inpatient Nurse - Managed Care CoordinationMedPOINT Management, a prominent Medical Services Organization, provides competitive compensation and benefits within a supportive work environment.Key Responsibilities:Oversee patient transfers to designated hospitals when admission to an out-of-network facility...

Job SummaryMedPOINT Management is seeking a highly motivated and detail-oriented Member Engagement Specialist to join our team. As a key member of our outreach team, you will play a critical role in engaging members to schedule appointments for preventive care and chronic care services.Key Responsibilities:Utilize member gap reports to contact members and...

About the RoleWe are seeking a highly skilled Oncology Clinical Nurse Specialist to join our team at Clinical Management Consultants. As a key member of our healthcare team, you will be responsible for providing expert clinical guidance and support to our Oncology unit.Key ResponsibilitiesDevelop and implement evidence-based clinical practices to improve...

Job OverviewPosition SummaryThe Member Engagement Specialist plays a crucial role in fostering connections with members to facilitate appointments for preventive and chronic care services. This position also involves documenting interactions and generating reports to track scheduling achievements.Key Responsibilities1. Utilize member gap analysis to reach...

Job OverviewAt Cedars-Sinai, the work you do has a significant impact on the health and well-being of our community. Our commitment to excellence is reflected in our six consecutive Magnet designations for nursing quality. As part of a team of distinguished healthcare professionals, you will have access to cutting-edge facilities and resources to make a...

Job SummaryKaiser Permanente is seeking a skilled Case Manager Utilization RN to join our team. As a key member of our healthcare team, you will play a critical role in coordinating and managing the care of our patients.Key ResponsibilitiesCollaborate with Physicians: Work closely with physicians to develop and implement individualized plans of care that...