76 utilization review jobs at 32 companies in Los Angeles, CA
2w
Save
Mark Applied
Hide
Utilization Review RN
Ontario, California, United States
$72k-$104k/yr OnsiteFull Time
7+ YOERequires current state RN license, BCLS/BLS (AHA), knowledge of MCG or InterQual, minimum 7 years post-graduate nursing and 3+ years utilization review experience; strong clinical judgment and computer skills.
MCG Criteria, InterQual Criteria
4w
Save
Mark Applied
Hide
Utilization Review Nurse LVN
Ontario, California, United States
$72k-$100k/yr OnsiteFull Time
2+ YOEActive CA LVN license, 2+ years acute hospital case management, utilization management experience, knowledge of claims, coding and billing, high school diploma/GED, strong interpersonal skills.
1mo
Save
Mark Applied
Hide
Utilization Review Coordinator
Long Beach, California, United States
$26-$28/hr OnsiteFull Time
2+ YOEAuditing charts, managing Medi-Cal/TAR submissions and appeals, verifying insurance eligibility, maintaining patient and payer records, 2+ years behavioral health/hospital experience, EHR proficiency, strong communication and computer skills.
Electronic Health Records (EHR), LA County TAR Unit Database, Medi-Cal system
3w
Save
Mark Applied
Hide
Utilization Review Tech
Santa Ana, California, United States
$25-$37/hr OnsiteFull Time
High school diploma, strong administrative and insurance knowledge, ability to manage payer correspondence, HIPAA compliance, typing 50 WPM, Microsoft Office proficiency; healthcare experience preferred.
Microsoft Word, Microsoft Outlook, Microsoft Excel, ICD-10, CPT
3mo
Save
Mark Applied
Hide
Utilization Review (UR) Assistant
Long Beach, California, United States
$21-$26/hr OnsiteFull Time
1+ YOEHigh School graduate or GED preferred; 1 year acute care/hospital experience preferred; medical terminology knowledge required.
3w
Save
Mark Applied
Hide
Utilization Review Technician III
Ontario, California, United States
$25-$30/hr OnsiteFull Time
4+ YOEBachelor's degree or 4 years relevant experience, Microsoft Office proficiency, EMR experience, good communication; medical terminology and HIPAA knowledge preferred.
Electronic Medical Records (EMR), Microsoft Office
1mo
Save
Mark Applied
Hide
Utilization Review Supervisor RN
Rancho Cucamonga, California, United States
$78k-$120k/yr RemoteFull Time
3+ YOEActive RN licensure, graduate of accredited nursing program (diploma/associate required; BS/BSN preferred), 3+ years clinical experience (rehabilitation preferred), management/supervisory experience, national certification (CCM preferred), and Microsoft Office/Excel proficiency.
Microsoft Office, Microsoft Excel
2mo
Save
Mark Applied
Hide
CSMC 8750000 Utilization Management Utilization Review Case Manager CS_PER_DIEM 48010 Allen PD68 0.01
Los Angeles, California, United States
$68-$75/hr RemotePart Time
3+ YOEGraduate of accredited nursing program and current CA RN license required; BLS required; 3+ years acute care nursing experience; 2+ years case management preferred; knowledge of reimbursement and medical literature; flu vaccine required.
InterQual, MCG
4w
Save
Mark Applied
Hide
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
3w
Save
Mark Applied
Hide
Medical Director Utilization Management Oncology
Cerritos or California or Nevada or Arizona or Oregon or Florida
$275k-$325k/yr RemoteFull Time
5+ YOEMedical degree (MD or DO) and oncology board certification; minimum 5 years clinical oncology experience and 2+ years utilization management experience; strong analytical and communication skills; ability to review treatment appropriateness.
1mo
Save
Mark Applied
Hide
RN Case Manager - Utilization Review
Lynwood, California, United States
$47-$63/hr OnsiteFull Time
5+ YOECurrent Ohio RN license, minimum 5 years post-grad nursing experience, 1+ year case management/discharge planning, basic-intermediate computer skills; BCLS required/preferred, CCM preferred, Milliman/InterQual knowledge preferred.
Milliman Criteria, InterQual Criteria
2mo
Save
Mark Applied
Hide
Provider Quality Review Nurse, RN
Rancho Cucamonga, California, United States
$91k-$121k/yr RemoteFull Time
3+ YOEThree or more years in healthcare quality, QA, utilization management; RN license in California; Nursing bachelor’s degree; CPQH/CPRM or clinical certification preferred; valid CA driver’s license.
Spreadsheets, Databases, Word processing
2w
Save
Mark Applied
Hide
Remote - Family Medicine Utilization Review - 1099 (contract)
Los Angeles or Oregon or United States
RemoteContract
5+ YOEMD or DO, current Oregon medical license, board-certified in Family Medicine, 5+ years clinical experience, daytime availability, and adherence to HIPAA and company policies.
1mo
Save
Mark Applied
Hide
Coordinator, Office Utilization Review (FT, Days) Monterey Park Hospital
Monterey Park, California, United States
$26-$32/hr OnsiteFull Time
2+ YOEPerforms administrative UR duties including processing admissions, preparing TARs, coordinating discharges, communicating with case managers; Google Workspace knowledge preferred; 2 years acute care experience preferred.
Google Workspace
2mo
Save
Mark Applied
Hide
Registered Nurse - Utilization and Care Transitions
Riverside, California, United States
$50-$75/hr OnsiteFull Time
3+ YOEBachelor's in nursing, active CA RN license, current AHA BLS (hands-on) required, 3+ years clinical nursing with 1+ year in transitional care/case management or utilization review, valid CA driver's license and auto insurance, ability to travel locally.
EMR
6d
Save
Mark Applied
Hide
Clinical SIU Investigator
Los Angeles, California, United States
OnsiteFull Time
Experience in healthcare investigations, compliance, SIU, clinical auditing, utilization review, or medical record review; knowledge of medical necessity, fraud schemes, billing, claims review, and documentation standards.
1mo
Save
Mark Applied
Hide
Clinical Documentation Improvement Specialist - Clinical Document Improvement - Full Time 8 Hours Days (7:00AM to 5:30PM) (Non-Union, Non-Exempt)
Arcadia, California, United States
$46-$61/hr OnsiteFull Time
3+ YOEReview inpatient records, apply ICD-10/CPT coding knowledge, initiate documentation queries, collaborate with clinicians and coding staff, and support clinical documentation improvement with 3+ years clinical or utilization review experience.
Microsoft Windows, ICD-10 CM, ICD-10-PCS, CPT, HCPCS, AHA Coding Clinic
3mo
Save
Mark Applied
Hide
Case Manager - Care Coordinator - Full Time 8 hours Days (Union, Non-Exempt)
Arcadia, California, United States
$46-$76/hr OnsiteFull Time
3+ YOERN with 3+ years in utilization review/discharge planning; CA RN; BLS; associate nursing degree; strong communication and coordination skills.
1w
Save
Mark Applied
Hide
Administrative Assistant - Case Management - Per Diem
San Pedro, California, United States
$25-$38/hr OnsitePart Time
3+ YOERequires 3 years of healthcare experience, 2 years in utilization review, admitting, or a business office, medical terminology, and Microsoft Word and internet experience.
Microsoft Word, Internet
3mo
Save
Mark Applied
Hide
Case Manager, RN
Valencia, California, United States
OnsiteFull Time
2+ YOECoordinate care, utilization review, discharge planning; liaison with insurance and social services; manage care across continuum; InterQual/Milliman knowledge preferred.
InterQual, Milliman, Nursing practice standards
Explore Jobs
Expand Your Job Search
Top Cities Near Los Angeles for Utilization Review
- Utilization Review jobs in Long Beach, CA
- Utilization Review jobs in Anaheim, CA
- Utilization Review jobs in Santa Ana, CA
- Utilization Review jobs in Riverside, CA
- Utilization Review jobs in Irvine, CA
- Utilization Review jobs in Fontana, CA
- Utilization Review jobs in Huntington Beach, CA
- Utilization Review jobs in Glendale, CA
- Utilization Review jobs in Santa Clarita, CA
- Utilization Review jobs in Garden Grove, CA
- Utilization Review jobs in Rancho Cucamonga, CA
- Utilization Review jobs in Ontario, CA
- Utilization Review jobs in Corona, CA
- Utilization Review jobs in Lancaster, CA
- Utilization Review jobs in Palmdale, CA
- Utilization Review jobs in Pomona, CA
- Utilization Review jobs in Torrance, CA
- Utilization Review jobs in Pasadena, CA
- Utilization Review jobs in Orange, CA
- Utilization Review jobs in Fullerton, CA