The RN Utilization Management Lead (RN UM) is an onsite position responsible for overseeing the daily operations of the utilization management team to ensure effective, timely, and compliant review processes for medical necessity, prior authorization, eTARs, denials management, concurrent and retrospective review activities. Contacts insurance for pre-authorization prior to conversion; collaborates with CM RN to obtain order for admission if appropriate. Monitor daily workflow for timely completion of authorization reviews (pre-certification, concurrent, post-service). Ensure appropriate application of clinical guidelines (e.g., InterQual, MCG) and regulatory standards (e.g., CMS, NCQA, URAC). Other duties as assignedsuch as denials management and appeals in lieu of other UM duties.
3B Healthcare Inc. is seeking a travel nurse RN Wound Care for a travel nursing job in Los Angeles, California.. Facility: Cedars-Sinai Medical Center. Wound and Ostomy certification required, WCC or WOCN. ● Strategic Connections: With a strategic approach and an extensive network, we connect premier healthcare professionals with facilities across the United States.. JCC Certified: We are certified by The Joint Commission for our commitment to patient safety and quality of care.
Trustaff is seeking a travel nurse RN CVOR for a travel nursing job in Los Angeles, California. Job Description & Requirements Specialty: CVOR Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel As a CVOR RN, you'll be an important part of the cardiovascular operating room team. Cardiovascular Operating Room (CVOR) nurses must be able to monitor and coordinate procedures, problem solve, and ensure the highest levels of patient safety throughout the patient's time in the operating room. Posted job title: Operating Room - CVOR About Trustaff Our nurse-first attitude has set us apart from other travel nursing agencies When you join the Trustaff family, you’re more than just a body filling a role—you're a vibrant individual with dreams and aspirations. Some of the other reasons people choose us include: Priority access to thousands of travel nursing jobs Industry-leading pay Guaranteed weekly hours Experienced recruiters Comprehensive benefits, including medical, dental, and vision 401k with employer match Assistance with travel, compliance, and housing Great bonuses for completions, referring friends, and more Benefits Weekly pay Guaranteed Hours Wellness and fitness programs Referral bonus Medical benefits Dental benefits Vision benefits
PRIDE Health is seeking a travel nurse RN Home Health for a travel nursing job in Newport Beach, California.. Job Description & Requirements Specialty: Home Health Discipline: RN Start Date: 09/15/2025 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel The Home Health Hospice RN is responsible for providing skilled nursing care to patients in their homes, including medication management, treatment planning, patient counseling, and thorough clinical documentation.. This role supports patient comfort, adherence to treatment plans, and overall quality of care while maintaining compliance with infection control and clinical protocols.. Knowledge of infection control procedures and home health nursing standards.. Benefits Weekly pay Holiday Pay Guaranteed Hours 401k retirement plan Cancelation protection Referral bonus Medical benefits Dental benefits Vision benefits
Assess the medical necessity of procedures, tests, and treatments to ensure they align with established guidelines and criteria, such as those from the InterQual or Milliman Care Guidelines.. Ensure that utilization review practices comply with regulatory standards, including The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS), and other state or federal regulations.. Maintain up-to-date knowledge of healthcare regulations, coding guidelines (ICD-10, CPT), and payer-specific policies to ensure accurate documentation and compliance.. Prepare reports on utilization metrics, including patterns in hospital admissions, readmissions, and discharge delays, for management and leadership review.. Sterile Processing Tech's
VitalHire is seeking a travel Skilled Nursing Facility (SNF) Physical Therapist for a travel job in Reseda, California.. VitalHire is seeking a skilled and compassionate PT - SNF to join our growing clinician community.. Provide physical therapy services in a skilled nursing facility setting. Experience with EMR systems (Epic, Cerner, as applicable). Maximize your take-home with top tier, tax-free housing & travel stipends
Fusion Medical Staffing is seeking a skilled Operating Room RN for a 13-week travel assignment in Lynwood, California.. One year of recent experience as an Operating Room RN. The Operating Room Registered Nurse provides comprehensive patient care throughout the perioperative process, ensuring the safety and comfort of patients during surgical procedures.. The OR RN collaborates with multidisciplinary teams and adheres to the highest standards of patient safety, infection control, and professional ethics in a dynamic surgical environment.. Start your rewarding career as a Travel Operating Room RN with Fusion Medical Staffing and join our mission to improve lives.
Job Opportunity: RN - Rehabilitation Position Details Specialty: RN - Rehabilitation Location: Torrance, California Facility: All Medical Personnel Employment Type: Temporary Contract Length: 8 weeks Job Description Coordinates total nursing care for patients.. Provides leadership by working cooperatively with ancillary nursing and other patient team personnel.. Patient Population: Adult-Geriatric Requirements Experience: 2+ years of RN - Rehabilitation experience required.. Benefits: Travel and housing provided.. Compliance: All medical/occupational health compliance items must be completed within 5 days of offer acceptance.
The Registered Nurse (RN) will provide compassionate, low-barrier nursing care to unhoused individuals in a facility, an adult residential SUD treatment facility and wellness center in Skid Row. As a key member of a multidisciplinary team, the RN will deliver direct care, oversee nursing support, collaborate with providers, and uphold clinical protocols to promote recovery and overall wellness.. This role is essential to our mission of offering transformative, trauma-informed care rooted in harm reduction and social justice.. - Deliver patient-centered nursing services, including assessments, individualized care plans, wound care, medication administration, phlebotomy, and care coordination.. - Collaborate with social workers, case managers, and harm reduction specialists to address complex medical, mental health, and substance use needs.. - Guide and support Medical Assistants, assist with staff orientation, and facilitate training on harm reduction practices.
LocumJobsOnline is working with CompHealth to find a qualified Hematology and Oncology NP in Santa Monica, California, 90404!. Let us do the heavy lifting and handle the headache of credentialing, travel, housing, and so much more. With the premier staffing agency as your champion, you can achieve more success with less worry. Our company dates back to 1979, when two physicians created the locum tenens industry as a way to meet the needs of rural hospitals in desperate need of healthcare professionals. And with more than 1,000 specialized recruiters and in-house licensing, credentialing, travel, and legal teams, we can take care of all the details, whatever the position.
I m working with an amazing private practice outpatient treatment and infusion center.. This is a dynamic, expanding concierge infusion clinic located in Los Angeles, and they are looking for a full-time, permanent LVN to join their team of compassionate, enthusiastic, and highly skilled medical professionals.. Answer directly to the Nurse Supervisor, MD, and administrative staff.. Bloodborne pathogen/biohazard exposure protocols.. Blood collection/specimen preparation for PRP
Location: Rochester General Hospital.. The Medical Short-Stay Unit at Rochester General Hospital is 33 bed shared unit caring for patients with hospital stays expected to be less than 48 hours. Complies with organizational policies, procedures and protocols including policies governing safety, medication administration and documentation. BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department (NYSED).. The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant.
Travel ICU RN Company: Fusion Medical Staffing. Job Details Fusion Medical Staffing is seeking a ICU RN for a 13-week travel assignment in Anaheim, California.. Required Qualifications: One year of recent experience as an ICU RN Valid RN license in compliance with state regulations Current BLS (AHA/ARC) and ACLS (AHA/ARC) certifications Preferred Qualifications: Critical Care Registered Nurse (CCRN) certification TNCC, NIHSS certification Other certifications or licenses may be required for this position Summary: The ICU Registered Nurse is responsible for providing comprehensive, critical care to patients in the intensive care unit.. The position requires strong critical care skills, advanced clinical judgment, excellent communication, and a commitment to maintaining the highest standards of patient safety and professional ethics in high-acuity settings.. Start your rewarding career as a Travel ICU RN with Fusion Medical Staffing and join our mission to improve lives.
Must Have: Nurse Practitioner, Orthopedic/Pain Management, Clinical Management. We are seeking a dynamic and highly organized Nurse Practitioner (NP) to serve as the Care Services Clinical Manager supporting a multi-physician orthopedic practice.. This is an ideal position for an advanced practice provider who thrives in a fast-paced clinic environment and enjoys having a high level of responsibility in both clinical and administrative domains.. Coordinate surgical scheduling, pre-op clearances, imaging protocols, and insurance authorizations.. Order and interpret diagnostic studies including X-rays, MRIs, CTs, and labs.
Job Title: Case Management Assessment Specialist – Remote (RN, California Licensed). Location: Fully Remote – Anywhere in the U.S.. Wheeler Staffing Partners is seeking a Case Management Assessment Specialist (RN) to join a remote care management team.. Maintain and document CFNA and ICP in the medical management platform accurately and efficiently.. Fully remote opportunity with flexible work-from-home environment.
A work ethic forged in the Midwest, we are here to stand by your side and help you find your dream assignment anywhere in this great country.. THE POSITION:The Home Health Nurse provides skilled nursing care to patients in their homes, focusing on promoting health, preventing disease, and helping patients manage chronic conditions.. This role involves coordinating care with physicians, therapists, and other healthcare professionals to ensure a high standard of care and patient safety.. We provide group benefits for Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Accident, Critical Illness, and Identity Theft Protection.. Employee Assistance ProgramFree to all employees who’d like information on personal issues: Education, Dependent Care, Care Giving, Legal, Financial, Lifestyle & Fitness Management, Working Smarter.
At Houston Methodist, nurses develop their skills through a wide range of educational programs, collaborate with physicians to provide the best care and build upon a world-class reputation for excellence in patient care, education and research.. Our growing, inclusive health care system offers: Superior practice settings High safety standards Professional development & nursing education Meaningful collaboration with physicians Unparalleled support Requirements Bachelor of Science degree or higher from an accredited School of Nursing Twelve months registered nurse experience in a healthcare environment Texas RN license or temporary TX RN license, should obtain permanent license within 90 days.. COMPASSION We embrace the whole person and respond to emotional, ethical and spiritual concerns as well as physical needs.. About Houston Methodist Baytown Hospital Houston Methodist Baytown Hospital, located 35 miles southeast of Houston, is the area's only full-service hospital offering specialized medical care for patients at every stage in life.. The hospital brings Texas Medical Center excellence and quality care close to East Harris and surrounding counties.
Registered Nurse (RN) Supervisor Evenings. Steuben Center for Rehabilitation and Healthcare is seeking an RN Supervisor to work Full-time evenings for our Skilled Nursing Facility located in Bath, NY. The ideal candidate will have strong interpersonal skills and three years of Long-term care experience!. Current Valid Registered Nurse (RN) license. Steuben Center for Rehabilitation and Healthcare has been the provider of long-term care services in Steuben County since 1834.. Steuben Center is a proud member of the Centers Health Care Consortium.
The Registered Nurse (RN) will provide compassionate, low-barrier nursing care to unhoused individuals in a facility, an adult residential SUD treatment facility and wellness center in Skid Row. As a key member of a multidisciplinary team, the RN will deliver direct care, oversee nursing support, collaborate with providers, and uphold clinical protocols to promote recovery and overall wellness.. This role is essential to our mission of offering transformative, trauma-informed care rooted in harm reduction and social justice.. - Deliver patient-centered nursing services, including assessments, individualized care plans, wound care, medication administration, phlebotomy, and care coordination.. - Collaborate with social workers, case managers, and harm reduction specialists to address complex medical, mental health, and substance use needs.. - Guide and support Medical Assistants, assist with staff orientation, and facilitate training on harm reduction practices.
The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with NeueHealth, dedicated to promoting quality and cost-effective outcomes for the designated population.. o Evaluate and process prior authorization requests for medical procedures, medications, and services based on clinical guidelines such as: Medicare criteria, Medicaid/Medi-Cal criteria, InterQual, MCG, or Health Plan specific guidelines.. o Familiarity with insurance authorization processes, medical billing, and coding (e.g., ICD-10, CPT codes).. o Working knowledge of MCG, InterQual, and NCQA standards.. o Experience with EMR systems and prior authorization platforms.