Medical Review Rn Jobs in California (NOW HIRING)

... Review RN responsible for concurrent reviews, medical necessity determinations, prior authorizations, continued stay reviews, and utilization management using InterQual criteria while ensuring ...

... Nursing Profession Registered Nurse Specialty Utilization Review Job ID 18027156 Job Title ... ensuring medical necessity, appropriate level of care, and compliance with CMS, EMTALA, and ...

... medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice.

As a RN Care Coordinator, you are responsible for overseeing the progression of care and discharge ... Mercy Medical Center Redding is a 266-bed regional medical center providing inpatient and ...

Vivo HealthStaff is searching for a Utilization Review RN for a hybrid position for a health plan ... Ensures medical necessity determinations, service authorization and concurrent denials are managed ...

... medical record for the medical necessity, intensity of service and severity of illness ... Minimum 3 years RN Utilization Manager working for a Health Plan. * At least 3 years of experience ...

Vivo HealthStaff is searching for a Utilization Review RN for a hybrid position for a health plan ... Ensures medical necessity determinations, service authorization and concurrent denials are managed ...

... medical record for the medical necessity, intensity of service and severity of illness ... Minimum 3 years RN Utilization Manager working for a Health Plan. * At least 3 years of experience ...

... the medical record for the medical necessity, intensity of service and severity of illness ... Minimum 3 years RN Utilization Manager working for a Health Plan. * At least 3 years of experience ...

Vivo HealthStaff is searching for a Utilization Review RN for a hybrid position for a health plan ... Ensures medical necessity determinations, service authorization and concurrent denials are managed ...

... medical record for the medical necessity, intensity of service and severity of illness ... Minimum 3 years RN Utilization Manager working for a Health Plan. * At least 3 years of experience ...

... medical record for the medical necessity, intensity of service and severity of illness ... Minimum 3 years RN Utilization Manager working for a Health Plan. * At least 3 years of experience ...

... medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice.

Utilization Review * Discipline: RN * Start Date: 08/24/2026 * Duration: 13 weeks * 40 hours per ... Durable Medical Equipment (DME) Coordination * Prior Authorizations * Benefits Eligibility ...

The QM Nurse assists in the coordination and collection of HEDIS medical records, identifies ... License Required Registered Nurse (RN) in the State of California About Us Hoag Memorial Hospital ...

Registered Nurse Specialty: Case Management Duration: 13 weeks Shift: Day 5x8-Hour Hours per Shift ... review process, ensuring compliance with medical necessity and admission criteria. Key ...

The Quality Management (QM) Nurse is responsible for preparing, reviewing, and presenting findings ... The QM Nurse assists in the coordination and collection of HEDIS medical records, identifies ...

The QM Nurse assists in the coordination and collection of HEDIS medical records, identifies ... License Required Registered Nurse (RN) in the State of California License Preferred N/A ...

Registered Nurse (RN) Facility: Estimated Pay: $2065.88 - $2160.88 Duration: 13 weeks Specialty ... Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife ...

Registered Nurse (RN) Facility: Hospital Estimated Pay: $2005.41 - $2100.41 Duration: 13 weeks ... Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife ...