NewTravel Nurse RN - Utilization Review - $2,065 to $2,160 per week in Mission Viejo, CA GQR HealthcareTravel Nurse RN - Utilization Review - $2,065 to $2,160 per week in Mission Viejo, CAMission Viejo, CA$2,065–$2,160As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
NewTravel Nurse RN - Utilization Review - $1,948 to $2,043 per week in Mission Viejo, CA GQR HealthcareTravel Nurse RN - Utilization Review - $1,948 to $2,043 per week in Mission Viejo, CAMission Viejo, CA$1,948–$2,043As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
NewTravel Nurse RN - Utilization Review - $1,904 per week in Santa Monica, CA GQR HealthcareTravel Nurse RN - Utilization Review - $1,904 per week in Santa Monica, CASanta Monica, CA$1,904Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
Grievance and Appeals Nurse Specialist (LVN or RN) Kinetic Personnel GroupGrievance and Appeals Nurse Specialist (LVN or RN)Orange, CA$43–$65 / hourTemporaryUtilize computer and appropriate software (e.g., Microsoft Office: Excel, Outlook, PowerPoint, Word) and job-specific applications/systems to produce correspondence, charts, spreadsheets and/or other information applicable to the position assignment. A permanent position does include excellent CalPERS pension, 401a (4% contribution) and excellent government benefits and Holiday/PTO schedule.
NewNurse Manager LVN-LPN Regents Point - a HumanGood communityNurse Manager LVN-LPNDiamond Bar, CA$85,000–$95,000Actively engages residents in participation in daily activities which are part of resident’s rhythm of daily life (including desired hygiene, grooming, and mobility); Assesses resident’s needs at the time of admission and continually evaluates residents’ condition during the duration of their stay and promotes the highest functional level of independence possible (keeping in compliance with state and federal regulations, and the community’s safety procedures); Responds to emergency situations, carries out physician orders, and documents the event, interventions, and outcomes; Coordinates the residents’ plan of care with the interdisciplinary team (IDT), physicians, medical personnel, and resident’s family/responsible party; Interacts with other departments such as laboratory, radiology, dietary, facilities, information technology, pharmacy, social services, activities, etc; Makes daily rounds and reports any unusual changes to the Director of Nursing. Regents Point, a premier 5-star HumanGood life plan community (CCRC) in Irvine, CA, is seeking a dedicated and experienced Nurse Manager LVN-LPN to join our team.
Case Manager RN Health Source MSOCase Manager RNAlhambra, CAFull timeMonitors nursing and medical plans of care/discharge plans and provides appropriate interventions to assure care is appropriate, coordinated and that avoidable patient days are addressed effectively through education, consultation, and counseling as needed. Ensures collaboration between multidisciplinary healthcare team members, primary physician, community agencies, HMOs/PPOs, CCS, etc., whose services may be required and/or related to the care needs of the patient after hospital discharge.
NewCertified Registered Nurse Anesthetist (CRNA), Fontana (Full Time) Kaiser PermanenteCertified Registered Nurse Anesthetist (CRNA), Fontana (Full Time)Fontana, CASuch intervention may include, but not be limited to: airway management; maintenance of fluid balance; homeostasis; monitoring; response to emergencies related to airway management and cardiopulmonary resuscitation; and management of patients on ventilators. Demonstrates an understanding of the cognitive, physical, emotional and chronological maturation process in delivery of services to patients of each age group served: neonatal, pediatric, adolescent, adult and geriatric.
NewCertified Registered Nurse Anesthetist (CRNA), South Bay/Harbor City (Full Time) Kaiser PermanenteCertified Registered Nurse Anesthetist (CRNA), South Bay/Harbor City (Full Time)Harbor City, CASuch intervention may include, but not be limited to: airway management; maintenance of fluid balance; homeostasis; monitoring; response to emergencies related to airway management and cardiopulmonary resuscitation; and management of patients on ventilators. Demonstrates an understanding of the cognitive, physical, emotional and chronological maturation process in delivery of services to patients of each age group served: neonatal, pediatric, adolescent, adult and geriatric.
NewCertified Registered Nurse Anesthetist (CRNA), Downey (Full Time) Kaiser PermanenteCertified Registered Nurse Anesthetist (CRNA), Downey (Full Time)Downey, CA$123.43Such intervention may include, but not be limited to: airway management; maintenance of fluid balance; homeostasis; monitoring; response to emergencies related to airway management and cardiopulmonary resuscitation; and management of patients on ventilators. Demonstrates an understanding of the cognitive, physical, emotional and chronological maturation process in delivery of services to patients of each age group served: neonatal, pediatric, adolescent, adult and geriatric.
NewNURSE PRACTITIONER Comprehensive Community Health Centers Inc.NURSE PRACTITIONERBell, CA$110,000–$140,000 / yearTo perform a variety of advanced clinical duties involved in assessing, treating, controlling, and preventing patient illness and disease within the assigned public health nursing program; to perform physical examinations; identify patients with physical and emotional illness; and to administer medications as prescribed. Assists in the establishment and maintenance of CCHC quality improvement program that monitors important aspects of care, identifies problems in care, implements changes to improve care, and evaluated effectiveness of action taken.
NewCertified Nurse Assistant Full Time Temporary Royal Oaks - a HumanGood communityCertified Nurse Assistant Full Time TemporaryPomona, CA$22–$25You would develop awareness of residents’ interests and needs, and assist residents to maximize their independence and participation by providing exemplary care to residents ranging from basic needs, to activities of daily living, to recreational activities. Royal Oaks in Duarte, CA, one of several HumanGood communities recognized as a Best CCRC-2026 by U.S. News & World Report, is seeking a Full time Certified Nurse Assistant to join our Skilled Nursing Team.
NewCertified Nurse Assistant Full Time Royal Oaks - a HumanGood communityCertified Nurse Assistant Full TimeAzusa, CA$22–$25You would develop awareness of residents’ interests and needs, and assist residents to maximize their independence and participation by providing exemplary care to residents ranging from basic needs, to activities of daily living, to recreational activities. Royal Oaks in Duarte, CA, one of several HumanGood communities recognized as a Best CCRC-2026 by U.S. News & World Report, is seeking a Full time Certified Nurse Assistant to join our Skilled Nursing Team.
Case Management Coordinator Health Source MSOCase Management CoordinatorAlhambra, CAFull timeJob Description: In the UM department, Case Management Coordinator is to assist with the coordinating of the day-to day activities in the medical group, request for authorization for ancillary services, and certify the group is utilizing the most cost effective provider. Also, identify patients found in out-of-network facilities and send the information timely to the concurrent-review nurse for coordination with the hospital and group.
NewSRS - Lead – RN - Pediatrics - Full Time - Day Shift SHARP HEALTHCARESRS - Lead – RN - Pediatrics - Full Time - Day ShiftLos Angeles, CA$200,000–$240,000 / yearThe actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. Demonstrates typing skills proficiency by: Using a keyboard, required to type proficiently and accurately; Have the ability to type a minimum of 30 words per minute with 0-2 errors; Have the ability to proof work.
NewCare Manager RN Per Diem Day Providence Health and ServicesCare Manager RN Per Diem DayTorrance, CA$57.28–$88.92 / hourOur not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School. Providence Saint John's Health Center has been recognized as a Magnet® hospital in 2025 —a prestigious designation from the American Nurses Credentialing Center (ANCC), which recognizes organizations that provide the highest-quality care.
NewCare Manager RN Full- time Day Providence Health and ServicesCare Manager RN Full- time DayInglewood, CA$57.28–$88.92 / hourOur not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School. Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care.
NewCare Manager RN Per Diem Variable Providence Health and ServicesCare Manager RN Per Diem VariableTorrance, CA$57.28–$88.92 / hourOur not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School. Providence Little Company of Mary in Torrance is celebrated in 2025 as one of America’s Best-In-State Hospitals by Newsweek and recognized by U.S. News & World Report for excellence in 11 types of care.
NewPhysician Assistant II / NP II - Neurosurgery, Per Diem (Fontana) Kaiser PermanentePhysician Assistant II / NP II - Neurosurgery, Per Diem (Fontana)Fontana, CAFunction in an expanded role to regularly provide primary, acute or emergency care to patients with complicated medical or surgical conditions which requires an intensive level of care and advanced certification in a specialty area (e.g., neonatal, intensive care, emergency medicine, operating room, etc.). Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.
Facility Site Review Nurse UCLA Health SystemFacility Site Review NurseLos Angeles, CA$37.60–$78.35 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. The Facility Site Review Nurse serves as a key liaison between provider sites, clinic leadership, office staff, contracted health plans, and other stakeholders to ensure compliance and support performance improvement initiatives.
Clinical Review Nurse - Prior Authorization AkidoClinical Review Nurse - Prior AuthorizationChino, CA$62,400–$93,600 / yearServing 500K+ patients across California, Rhode Island, and New York, Akido offers primary and specialty care in 26 specialties—from serving unhoused communities in Los Angeles to ride-share drivers in New York. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal.
Utlization Review RN eTeam Inc.Utlization Review RNOrange, CA$60–$65 / hourCandidate must be highly proficient in EPIC and InterQual, with demonstrated experience using both systems for clinical review and medical necessity determination. Pre-approved time off per contract no to exceed 5 days.
CA Utilization Review Nurse I CorVel CorpCA Utilization Review Nurse IRancho Cucamonga, CARemote$30.64–$45.80 / hourThe Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Facility Site Review Nurse University of CaliforniaFacility Site Review NurseLos Angeles, CA$37.60–$78.35 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. The Facility Site Review Nurse serves as a key liaison between provider sites, clinic leadership, office staff, contracted health plans, and other stakeholders to ensure compliance and support performance improvement initiatives.
UM Review Nurse - LVN Astrana Health IncUM Review Nurse - LVNMonterey Park, CARemoteIn this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans. We are seeking nurses with at least one year of outpatient UM experience in a fast-paced setting.
Provider Quality Review Nurse, RN Inland Empire Health PlanProvider Quality Review Nurse, RNRancho Cucamonga, CAThree (3) or more years of any individual or combined healthcare experience in quality assurance, quality management, quality improvement, utilization management, discharge planning, and/or case management. Certified Professional in Healthcare Quality (CPHQ), Certified Professional in Healthcare Risk Management (CPHRM), or Clinical certification in area specialty) preferred.
UM Review Nurse Astrana Health IncUM Review NurseMonterey Park, CARemoteIn this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans. We are seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting.
UM Review Nurse Astrana Health, Inc.UM Review NurseMonterey Park, CaliforniaRemote$34–$47 / hourComplete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans.
CA Utilization Review Nurse I CorVel Healthcare CorporationCA Utilization Review Nurse IRancho Cucamonga, CARemote$30.64–$45.80 / hourPart timeThe Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
RN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr Emanate Health Medical CenterRN - Quality Assurance/Utilization Review - Business Development - Full Time 8hrCovina, CA$52.03–$80.64 / hourComplete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings. On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country.
LVN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr Emanate Health Medical CenterLVN - Quality Assurance/Utilization Review - Business Development - Full Time 8hrCovina, CA$31.03–$46.54 / hourComplete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings. On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country.
Concurrent Utilization Review Nurse, RN NeueHealth IncConcurrent Utilization Review Nurse, RNCA$74,286.15–$111,429.23 / yearBy uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid. Job Summary: The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews to ensure the medical necessity and appropriateness of healthcare services provided to members under a managed care health plan.
Utilization Management Nurse, Senior- Medicare Concurrent Review Blue Cross and Blue Shield AssociationUtilization Management Nurse, Senior- Medicare Concurrent ReviewLong Beach, CARequires a current California RN License Requires at least 5 years of prior relevant experience Requires strong communication and computer navigation skills Desires strong teamwork and collaboration skills Requires independent motivation and strong work ethic Requires strong critical thinking skills Hybrid Virtual Work This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need. Your Work In this role, you will: Perform prospective, concurrent and retrospective utilization reviews and first level determination approvals for members using BSC and CMS evidenced based guidelines, policies and nationally recognized clinal criteria for BSC Medicare line of business.
Utilization Review LPN LVN Providence Health & ServicesUtilization Review LPN LVNAnaheim, CARequsition ID: 443485 Company: Providence Jobs Job Category: Health Information Management Job Function: Revenue Cycle Job Schedule: Part time Job Shift: Multiple shifts available Career Track: Nursing Department: 7520 UTIL MGMT CA HERITAGE Address: CA Anaheim 200 W Center St Promenade Work Location: St Joseph Home Health-Anaheim Workplace Type: On-site Pay Range: $40.89 - $63.48 Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Utilization Review LPN LVN Providence St. Joseph HealthUtilization Review LPN LVNAnaheim, CATogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Utilization Review Supervisor RN CorVel CorpUtilization Review Supervisor RNRancho Cucamonga, CARemote$77,960–$120,368 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
NewRN Case Manager Utilization Review Prime Healthcare Services IncRN Case Manager Utilization ReviewLynwood, CA$47.20–$63.45 / hourRequired Qualifications: Minimum 5 years'' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license At least one year experience in case management, discharge planning or nursing management Experience and knowledge in basic to intermediate computer skills. The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.
NewRN Case Manager - Utilization Review St. Francis Medical CenterRN Case Manager - Utilization ReviewLynwood, California$47.20–$63.45 / hourFull timeThe methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
NewCare Review Clinician (RN) Remote Molina Healthcare IncCare Review Clinician (RN) RemoteCARemoteResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Care Review Clinician (RN) - Reside in PST Molina Healthcare IncCare Review Clinician (RN) - Reside in PSTCAResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Registered Nurse/Utilization Review APN Consulting IncRegistered Nurse/Utilization ReviewWhittier, CAThe EPR-RN performs, and supervises the EPRN-LVN, in utilization review with a prominent level of expertise by using approved criteria that demonstrates medical necessity to achieve appropriate authorization and reimbursement for services for the appropriate level of care and status (Inpatient, Observation, or Outpatient). The Emergency Prospective Review (EPR) Nurse RN has the responsibility to conduct a review of all patients requiring hospital admission from the emergency room at all PIH and non-PIH facilities (for PHP members) after stabilizing care has been initiated for medical necessity and appropriateness.
Utilization Review Supervisor RN CorVel Healthcare CorporationUtilization Review Supervisor RNRancho Cucamonga, CARemote$77,960–$120,368 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
Clinical Review Clinician Appeals RN Centene Corporation GroupClinical Review Clinician Appeals RNCA$27.02–$48.55 / hourEducation/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 - 4 years of related experience. Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices.
RN Utilization Review - Per Diem - REMOTE Providence St. Joseph HealthRN Utilization Review - Per Diem - REMOTEIrvine, CARemoteThe Utilization Management RN must effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
RN Utilization Review - Per Diem - REMOTE Providence Health & ServicesRN Utilization Review - Per Diem - REMOTEIrvine, CARemote$57.28–$88.92 / hourRequsition ID: 434193 Company: Providence Jobs Job Category: Health Information Management Job Function: Revenue Cycle Job Schedule: Part time Job Shift: Multiple shifts available Career Track: Nursing Department: 7000 UTILIZATION MGMT OCHD Address: CA Irvine 15480 Laguna Canyon Rd Work Location: Providence System Offices Discovery Park-Irvine Workplace Type: On-site Pay Range: $57.28 - $88.92 Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School.
RN Nurse Utilization Review - Full Time, Days (Los Angeles) NOR Healthcare SystemsRN Nurse Utilization Review - Full Time, Days (Los Angeles)Bellflower, CAFull timeThe Utilization Review/Management Nurse is also responsible in performing and completing medical necessity reviews utilizing McG and Interqual Review Guidelines ensuring adherence to said guidelines for admission and continued stay reviews. Maintains open lines of communication with Case Managers and Discharge Coordinators to ensure patient's safe and timely transition to the next appropriate level of care based on identified post-acute services needed.
Manager, Clinical Case Review Edwards LifesciencesManager, Clinical Case ReviewIrvine, CAThe Case Review Manager leads the patient screening analysis and evaluation of baseline medical history and clinical imaging reports (e.g EDC screening records including clinic notes, lab results, cardiology assessments, CT and/or echocardiogram reports) to confirm protocol compliance and provide patient screening and case review support to clinical trial sites for Clinical Research Trials within THV Clinical Affairs. + Previous related experience working a clinical setting or equivalent work experience based on Edwards criteria Preferred and Experience working in the setting of a clinical trial or equivalent work experience based on Edwards criteria Preferred.
Care Review Clinician I Integrated Resources, IncCare Review Clinician ILong Beach, CARemote$43–$44 / hourDescription: The Care Review Clinician is responsible for performing utilization management (UM) reviews, including prior authorization of outpatient services, to ensure medical necessity, appropriate level of care, and compliance with regulatory and organizational guidelines. The clinician will review clinical documentation, apply evidence-based criteria, and collaborate with providers to facilitate timely and appropriate care for members.
NewItemized Bill Review Auditor III (IBR) ExlService Holdings IncItemized Bill Review Auditor III (IBR)CA$70,000–$90,000 / yearEXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others.
Care Review Clinician, RN/LPN Molina Healthcare IncCare Review Clinician, RN/LPNLong Beach, CAResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years health care experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.