14 um nurse jobs at 7 companies in Carson, CA
1mo
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UM Nurse Manager II, Hospital
Downey, California, United States
$213k-$246k/yr OnsiteFull Time
5+ YOE4+ MgmtBSN and active California RN required; 5+ years patient care experience, 5 years business/clinical operations experience, 4+ years leadership; BLS required; PALS and ANCC preferred; experience managing hospital nursing operations.
3w
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Outpatient UM Coordinator
Sherman Oaks, California, United States
$21-$23/hr HybridFull Time
1+ YOEClinical background required (LVN/RN preferred),1-3 years UM/prior authorization experience, knowledge of outpatient terminology,CPT/ICD-10 coding,InterQual/Milliman familiarity,proficient with UM systems and Microsoft Office.
InterQual, Milliman, Microsoft Office Suite, CPT, ICD-10
3w
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Medical Review Nurse (RN) - UM/Appeals experience
Florida or Long Beach
OnsiteFull Time
2+ YOEActive unrestricted RN license, 2+ years clinical nursing with ≥1 year utilization review or claims review, knowledge of ICD-10/CPT/HCPC, regulatory requirements, and strong analytic and communication skills.
ICD-10, CPT, HCPC, MCG/InterQual, Microsoft Office
2mo
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Outpatient UM Clinician
Sherman Oaks or United States
$36-$48/hr RemoteFull Time
2+ YOELicensed clinician (nursing, social work, or related), 2+ years utilization or case management experience, proficient with electronic health records, strong communication and regulatory knowledge.
Electronic Health Records (EHR)
2mo
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Managed Long Term Services and Supports Nurse Specialist RN II (Los Angeles, CA, US, 90017)
Los Angeles, California, United States
$89k-$142k/yr OnsiteFull Time
3+ YOEActive California RN license, Associate's in Nursing required (BSN preferred), 3+ years clinical nursing or UM/CM experience, strong communication and clinical judgment, proficiency with Microsoft Office and L.A. Care systems, ability to travel to offsite locations.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Teams, L.A. Care Information System
1mo
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Utilization Management Nurse Specialist RN II
Los Angeles, California, United States
$89k-$142k/yr OnsiteFull Time
5+ YOEActive California RN license, 5+ years varied acute hospital RN experience, 2+ years UM/CM experience, managed care knowledge preferred, strong computer and communication skills, NCQA/DHCS/CMS knowledge preferred, HIPAA compliance.
Outlook, Word, Excel, PowerPoint, L.A. Care Information System
2mo
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Clinical Review Nurse - Prior Authorization
Pomona, California, United States
$62k-$94k/yr OnsiteFull Time
3+ YOEActive California LVN or RN license; 3-5+ years clinical UM review; prior authorization in managed care; knowledge of MCG criteria; EZCap experience preferred; California DMHC/CMS knowledge.
EZCap, MCG guidelines
2mo
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RN- Care Review Clinician- Utilization Review (Remote- CA License Req)
San Francisco or Los Angeles or San Jose or San Diego or Sacramento or Long Beach or California
$30-$59/hr RemoteFull Time
2+ YOEActive unrestricted RN license in state of practice (CA required for this posting), 2+ years clinical experience (acute care/prior authorization/managed care), UM/prior authorization experience preferred, Microsoft Office proficiency, strong communication and critical-thinking skills.
Microsoft Office, MCG
3w
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Care Review Clinician (RN) - (IL Nursing License)
Long Beach or Illinois
$24-$51/hr RemoteFull Time
2+ YOEActive Illinois RN license, 2+ years clinical/UM experience, proficiency with Microsoft Office, strong communication, organization and clinical decision-making skills.
Microsoft Office
1mo
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Care Review Clinician (RN) - (IL Nursing license)
Long Beach or Illinois or United States
RemoteFull Time
2+ YOEActive unrestricted Illinois RN license required, 2+ years clinical/UM experience, proficiency with MCG guidelines and Microsoft Office, strong clinical judgment and communication skills.
MCG, Microsoft Office
3w
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Case Manager, RN - Value Based Service Org - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Los Angeles, California, United States
$55-$91/hr HybridFull Time
5+ YOEActive CA RN with 5+ years clinical experience and 2+ years ambulatory case management; BLS required; strong computer skills and knowledge of CM/UM standards and guidelines.
InterQual, MCG
3w
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Care Review Clinician (RN) Remote (Must Reside In AZ)
Arizona or Long Beach
$26-$51/hr RemoteFull Time
2+ YOEActive unrestricted RN license in state of practice, 2+ years acute care/UM/prior authorization experience, Microsoft Office proficiency, strong communication, organization, and critical thinking skills.
Microsoft Office
2mo
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Utilization Management Assistant Director - RN
Los Angeles, California, United States
$116k-$265k/yr HybridFull Time
5+ YOE3+ MgmtLead ICM and UM programs; supervise RN and social work staff; ensure CMS/NCQA compliance; 5-7 years clinical with 3-5 years leadership; CA RN license; BSN.
Microsoft Excel, Visio, PowerPoint, Word
1mo
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Care Review Clinician (RN) Remote
Florida or Long Beach
$26-$51/hr RemoteFull Time
2+ YOEActive unrestricted RN license in state of practice, 2+ years clinical/inpatient/managed care/UM experience, BLS/CPR preferred, strong Microsoft Office and documentation skills, excellent communication and critical thinking.
Microsoft Office