• Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse * or Medical Service Coordinator, CCS.** -OR- OPTION ... UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333)...needed, and to make recommendations on potential areas for medical care evaluation studies. + Attends Utilization Review… more
    The County of Los Angeles (08/18/25)
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  • Sr. Claim Representative Construction…

    Travelers Insurance Company (Diamond Bar, CA)
    …Utilizes evaluation documentation tools in accordance with department guidelines. + Proactively review Claim File Analysis (CFA) for adherence to quality ... negotiating and resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim … more
    Travelers Insurance Company (06/03/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical ...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (06/28/25)
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  • Payment Integrity Nurse Coder RN III

    LA Care Health Plan (Los Angeles, CA)
    … and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. ... Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position...team lead on any issues identified during research or claims review . Applies subject expertise in evaluating… more
    LA Care Health Plan (08/23/25)
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  • LVN - Quality Assurance/Utilization Review…

    Emanate Health (Covina, CA)
    …United States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical … more
    Emanate Health (07/23/25)
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  • Registered Nurse I/Relief Nurse

    The County of Los Angeles (Los Angeles, CA)
    REGISTERED NURSE I/RELIEF NURSE Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3394509) Apply  REGISTERED NURSE I/RELIEF NURSE ... Date 02/07/2022 + Description + Benefits + Questions Position/Program Information REGISTERED NURSE I: $8,006.34 - $11,984.48 MONTHLY RELIEF NURSE : $57.41 to… more
    The County of Los Angeles (06/05/25)
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  • Public Health Nurse - Citywide

    City and County of San Francisco (San Francisco, CA)
    …San Francisco is accepting applications for permanent Clinical 2830 Public Health Nurse positions. Rather than publishing separate job ads, this ad collects ... of them. The Department of Public Health can then review your application and contact you directly with details...recruitment may be used to fill 2830 Public Health Nurse positions for the next six months. SHIFTS: Varied.… more
    City and County of San Francisco (08/09/25)
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  • Registered Nurse I, Sheriff (Correctional…

    The County of Los Angeles (Los Angeles, CA)
    REGISTERED NURSE I, SHERIFF (CORRECTIONAL HEALTH) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2930992) Apply  REGISTERED NURSE I, ... of Los Angeles is currently offering up to 20% bonus for full-time Registered Nurse I, Sheriff positions hired by Correctional Health Services and working on-site in… more
    The County of Los Angeles (07/07/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Sacramento, CA)
    …within time zone of residence.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, ... Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.… more
    CVS Health (08/15/25)
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  • Case Manager, Registered Nurse

    Sutter Health (San Francisco, CA)
    …quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and ... patient experience. The RN Case Manager works in collaboration with the Physician, Medical Social Worker and bedside RN to assure the timely movement of patients… more
    Sutter Health (08/16/25)
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