Healthcare Management Nurse Specialist

3 weeks ago


Los Angeles, California, United States L.A. Care Health Plan Full time
About the Job

We are seeking an experienced Healthcare Management Nurse Specialist to join our team at L.A. Care Health Plan. In this role, you will be responsible for performing telephonic and/or onsite admission and concurrent review, collaborating with onsite staff, physicians, providers, and members to develop and implement successful discharge plans. You will also work closely with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service, and retrospective claims medical review.

**Responsibilities:**

  • Perform telephonic and/or onsite admission and concurrent review.
  • Collaborate with onsite staff, physicians, providers, and members to develop and implement successful discharge plans.
  • Work closely with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service, and retrospective claims medical review.

Benefits: As a valued member of our team, you will enjoy a competitive salary range of $88,854.00 (Min.) - $142,166.00 (Max.), plus a comprehensive benefits package, including Paid Time Off (PTO), Tuition Reimbursement, Retirement Plans, Medical, Dental, and Vision, Wellness Program, and Volunteer Time Off (VTO).



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