38 Utilization Management Nurse jobs in Los Angeles, California, United States

United States (Remote)

$71.1–97.8K / year

Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the…

United States (Remote)

$70–75K / year

The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state…

United States (Remote)

$36.00 – $38.00 / hour

Vida is looking for a licensed RN or LPN to manage clinical review requests, escalations, and member inquiries in a fully remote, virtual care setting.

United States (Remote)

$27.00 – $49.00 / hour

Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating…

United States (Remote)

$82.7–96.5K / year

Job Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient,…

United States (Remote)

$78–83K / year

Our Story Imagine being part of a team that’s not just shaping the future but actively driving it.

United States (Remote)

This is a remote position.

United States (Remote)

$82–87K / year

The Clinical Compliance Auditor II is responsible for ensuring Guidehealth’s clinical operations, utilization management activities, and delegated…

United States (Remote)

$75.3–135.4K / year

Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members.

United States (Remote)

$100–130K / year

At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors.

United States (Remote)

$63.1–94.7K / year

Thank you for considering a career at Ensemble!

United States (Remote)

$47.00 – $63.00 / hour

Thank you for considering a career at Ensemble!

United States (Remote)

Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance…

United States (Remote)

$77.9–116.9K / year

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail.

United States (Remote)

$31.00 / hour

At Broadway Ventures , we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions.

United States (Remote)

Get To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit…

United States (Remote)

Overview HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an…

United States (Remote)

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes.

United States (Remote)

$35.00 – $40.00 / hour

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw…

United States (Remote)

$79.3–127.1K / year

Company : Highmark Inc.