• Appeals Nurse Reviewer I

    Elevance Health (Los Angeles, CA)
    **Appeals Nurse Reviewer I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... clinical domains, including radiology, cardiology and oncology. The **Appeals Nurse Reviewer I** is responsible for conducting...Outreach to providers with appeal process instructions. + Clinical review for the RBM and Surgical solution on a… more
    Elevance Health (09/26/25)
    - Related Jobs

  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working in… more
    The County of Los Angeles (10/06/25)
    - Related Jobs

  • 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 Center, one...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (09/27/25)
    - Related Jobs

  • UM Prior Authorization Review Nurse…

    UCLA Health (Los Angeles, CA)
    Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. This ... documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established… more
    UCLA Health (10/03/25)
    - Related Jobs

  • Intensive Case Management - Medicare Advantage…

    UCLA Health (Los Angeles, CA)
    …Under the direction of the Assistant Director, the ICM Medicare Advantage Utilization Review Nurse performs utilization review of medical necessity and ... enrolled under UCLA Medical Group. The ICM Medicare Advantage Utilization Review Nurse ensures that home health and durable medical equipment services are… more
    UCLA Health (10/02/25)
    - Related Jobs

  • Quality Management Clinical Nurse…

    UCLA Health (Los Angeles, CA)
    Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and ... inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan and/or… more
    UCLA Health (07/14/25)
    - Related Jobs

  • Senior Mental Health Nurse

    Ventura County (Ventura, CA)
    …assigned shifts. IDEAL CANDIDATE The ideal candidate is an experienced Mental Health Nurse with a background in utilization review and discharge planning. They ... Senior Mental Health Nurse Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061656) Apply  Senior Mental Health Nurse Salary $123,182.66 -… more
    Ventura County (09/26/25)
    - Related Jobs

  • Nurse Practitioner - Correctional Health

    The County of Los Angeles (Los Angeles, CA)
    …Please include the exam number and exam title. + Yes + No 08 NURSE PRACTITIONER CANDIDATE ASSESSMENT RATING FORMINSTRUCTIONS Review the four competency areas and ... to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your resume, education, experience, and achievements and… more
    The County of Los Angeles (09/03/25)
    - Related Jobs

  • Nurse Practitioner

    The County of Los Angeles (Los Angeles, CA)
    …Please include the exam number and exam title. + Yes + No 08 NURSE PRACTITIONER CANDIDATE ASSESSMENT RATING FORMINSTRUCTIONS Review the four competency areas and ... to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your resume, education, experience, and achievements and… more
    The County of Los Angeles (09/03/25)
    - Related Jobs

  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem ... Registered Nurse II/III - Utilization Management VCMC Salary $109,727.64 -...needed to assist with patient care coordination and utilization review . The incumbent will be responsible to assist with… more
    Ventura County (09/27/25)
    - Related Jobs