Top 225 Utilization management nurse Jobs in Los Angeles, Ca

RN Manager, Clinical Case Management - Full Time, Days
Southern California Hospitals —Culver City, CA
- $137,300 - $188,775 a year
- Full-time
- Nursing
- RN License
- Computer literacy
Registered Nurse Case Manager ED Full Time Nights
Martin Luther King, Jr. Community Hospital —Los Angeles, CA
- $53.07 - $82.27 an hour
- Full-time
- Background check
- Spanish
- Nursing
- Wellness program
- 403(b) matching
Quick Apply
ECM Registered Nurse
St Johns Community Health —Gardena, CA
- $100,000 - $101,000 a year
- Full-time
- Spanish
- Nursing
- RN License
- 403(b) matching
- Paid holidays
Quick Apply
Registered Nurse Manager - MLK BHC Residential
Health Right 360 —Los Angeles, CA
- $126,000 - $136,500 a year
- Full-time
- Background check
- Nursing
- Addiction Medicine
- Commuter assistance
- Paid holidays
Quick Apply
RN Case Manager - Case Management (ED) - Per Diem (12-hour night shifts) - Marina Hospital
Cedars-Sinai —Marina del Rey, CA
- $74.30 an hour
- 12 hour shift
- Acute care
- Nursing
- RN License
Utilization Management Nurse Specialist RN II
L.A. Care Health Plan —Los Angeles, CA
- $88,854 - $142,166 a year
- Weekends as needed
- Nursing
- Microsoft Outlook
- RN License
- Wellness program
- Health insurance
Case Manager - Intensive Case Management, Hybrid/Remote
UCLA Health —Los Angeles, CA
- $143,675 - $185,811 a year
- Remote
- Computer literacy
- Mid-level
- Windows
3d
Registered Nurse - Utilization Management
myPlace Care Partners, P.C. —Los Angeles, CA
- $53 - $58 an hour
- Full-time
- Nursing
- RN License
- Adults
- Wellness program
- Paid holidays
Quick Apply
13d
Utilization Management Supervisor, Non-Clinical
UCLA Health —Los Angeles, CA
- $70,900 - $145,200 a year
- Writing skills
- Mid-level
- 3 years
Utilization Management Nurse
Presidential Staffing Solutions, LLC —Los Angeles, CA
- $60 - $75 an hour
- Full-time
- Nursing
- 5 years
- Word processing
- Health insurance
- Dental insurance
Quick Apply
RN - Lead Care Manager (Full-Time, Day Shift)
Adventist Health —Los Angeles, CA
- Full-time
- Nursing
- Addiction Medicine
- RN License
RN - Lead Care Manager (Full-Time, Day Shift)
Adventist Health —Culver City, CA
- Full-time
- Nursing
- Addiction Medicine
- RN License
1d
RN - Lead Care Manager (Full-Time, Day Shift)
Adventist Health —Long Beach, CA
- Full-time
- Nursing
- Addiction Medicine
- RN License
1d
RN - Lead Care Manager (Full-Time, Day Shift)
Adventist Health —Baldwin Park, CA
- Full-time
- Nursing
- Addiction Medicine
- RN License
1d
Registered Nurse - Utilization Review Case Manager - PER_DIEM - 8 Hour Days
Cedars-Sinai —Los Angeles, CA
- $69 - $80 an hour
- 8 hour shift
- Nursing
- RN License
- BLS Certification
Utilization Management Nurse, LVN/LPN (Part Time)
NeueHealth —Los Angeles, CA
- $26.35 - $39.53 an hour
- Part-time
- Remote
- Nursing
- LVN
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
7d
RN Nurse Utilization Review - Full Time, Days (Los Angeles)
NOR Healthcare Systems —Bellflower, CA
- $56 - $77 an hour
- Full-time
- Nursing
- RN License
- Computer literacy
Case Manager - RN - Case Management - Full Time 8 hour Days (Non-Exempt) (Union)
Keck Medical Center of USC —Los Angeles, CA
- $47.31 - $100.00 an hour
- 8 hour shift
- Background check
- Nursing
- RN License
Utilization Management Admissions Liaison RN II
L.A. Care Health Plan —Los Angeles, CA
- $88,854 - $142,166 a year
- Full-time
- Acute care
- Nursing
- 7 years
- Wellness program
- Health insurance
RN Case Manager - Case Management - Part time - Day Shift - Marina del Rey Hospital
Cedars-Sinai —Marina del Rey, CA
- $59.90 - $92.84 an hour
- 8 hour shift
- Nursing
- RN License
- Hospital
- Referral program

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RN Manager, Clinical Case Management - Full Time, Days

Southern California Hospitals -
Culver City, CA

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Job Details

Full-time
$137,300 - $188,775 a year

Qualifications

Computer operation
Regulatory compliance
Computer skills
Acute care experience
Healthcare compliance

Full Job Description

Position Summary

The Manager of Case Management is accountable for overseeing all aspects of daily operations of the Case Management Department. Ensures standards of operations are in accordance with all state and federal healthcare regulatory guidelines. Works closely with Physician Advisors and Medical Directors assigned to the Facility(s). Attends the Utilization Management Committee. Under the direction of the Director of Case Management is responsible for employee coaching, training, hiring, counseling/discipline, performance assessment and payroll processes. Completes reports and analyzes data as assigned.

Responsibilities
- Assists Director of Case Management to implement strategic plans, unit/department goals and objectives, business initiatives, and to monitor financial plans and budgets. Complies with all policies/procedures, applicable laws and regulatory agency requirements, and organization work standards. Assumes responsibility for management decisions determined within the scope of this job description. Maintains records in compliance with legal and regulatory requirements. Demonstrates strategic and critical thinking; makes optimal use of resources; allocates and prioritizes work monitoring performance standards for continuous performance improvement.
- Assists to compile subject matter under the direction of the Director of Case Management for the Utilization Management Committee. Appropriately monitors and validates subject matter with the Director of Case Management prior to meeting. Ensures that avoidable and variance days are collected appropriately by case management staff. Verifies that the Directors of Case Management action plan is put in place, and goals are set, communicated, and met.
- Collaborates effectively with clinical and administrative leadership, physicians, nurses and a wide variety of other staff to ensure that service expectations and length of stay goals are met. Works with Director of Case Management to improve resource utilization, service delivery, work flow, etc. as necessary to meet established expectations. Ensures prompt and proper information exchanges and issue resolution. Appropriately informs Director of Case Management of issues needing immediate attention.
- Creates a safe work environment that fosters respect and positive morale. Effectively allocates and evaluates department work, and provides leadership and appropriate follow through to the Department. Effectively communicates with all staff. In cooperation with the Director of Case Management, interviews applicants and manages the hiring, firing, training, annual performance evaluations and competencies, and disciplinary process at assigned locations.
Required Qualifications:
- Current Licensure as a Registered Nurse and/or Licensed Clinical Social Worker in the State of California
- Two (2) years of leadership experience in Acute Care Case Management
- Excellent verbal and written communication skills
- Computer literate
- Knowledge of all Federal, State and Local regulatory standards
- Professional demeanor with Healthcare team
- Strong Organizational and Time Management skills with ability to effectively prioritize tasks
- Demonstrated Leadership Skills
Preferred Qualifications:
- Bachelors or Masters of Science in Nursing and/or Social Services
- InterQual or MCG criteria knowledge
- Certified Case Manager (CCM) or other Case Management/Nursing Certification
Pay Rate: Min -
The Manager of Case Management is accountable for overseeing all aspects of daily operations of the Case Management Department. Ensures standards of operations are in accordance with all state and federal healthcare regulatory guidelines. Works closely with Physician Advisors and Medical Directors assigned to the Facility(s). Attends the Utilization Management Committee. Under the direction of the Director of Case Management is responsible for employee coaching, training, hiring, counseling/discipline, performance assessment and payroll processes. Completes reports and analyzes data as assigned.

Responsibilities for Internal Candidates
- Assists Director of Case Management to implement strategic plans, unit/department goals and objectives, business initiatives, and to monitor financial plans and budgets. Complies with all policies/procedures, applicable laws and regulatory agency requirements, and organization work standards. Assumes responsibility for management decisions determined within the scope of this job description. Maintains records in compliance with legal and regulatory requirements. Demonstrates strategic and critical thinking; makes optimal use of resources; allocates and prioritizes work monitoring performance standards for continuous performance improvement.
- Assists to compile subject matter under the direction of the Director of Case Management for the Utilization Management Committee. Appropriately monitors and validates subject matter with the Director of Case Management prior to meeting. Ensures that avoidable and variance days are collected appropriately by case management staff. Verifies that the Directors of Case Management action plan is put in place, and goals are set, communicated, and met.
- Collaborates effectively with clinical and administrative leadership, physicians, nurses and a wide variety of other staff to ensure that service expectations and length of stay goals are met. Works with Director of Case Management to improve resource utilization, service delivery, work flow, etc. as necessary to meet established expectations. Ensures prompt and proper information exchanges and issue resolution. Appropriately informs Director of Case Management of issues needing immediate attention.
- Creates a safe work environment that fosters respect and positive morale. Effectively allocates and evaluates department work, and provides leadership and appropriate follow through to the Department. Effectively communicates with all staff. In cooperation with the Director of Case Management, interviews applicants and manages the hiring, firing, training, annual performance evaluations and competencies, and disciplinary process at assigned locations.
Qualifications for Internal Candidates

Required Qualifications:
- Current Licensure as a Registered Nurse and/or Licensed Clinical Social Worker in the State of California
- Two (2) years of leadership experience in Acute Care Case Management
- Excellent verbal and written communication skills
- Computer literate
- Knowledge of all Federal, State and Local regulatory standards
- Professional demeanor with Healthcare team
- Strong Organizational and Time Management skills with ability to effectively prioritize tasks
- Demonstrated Leadership Skills
Preferred Qualifications:
- Bachelors or Masters of Science in Nursing and/or Social Services
- InterQual or MCG criteria knowledge
- Certified Case Manager (CCM) or other Case Management/Nursing Certification
Pay Rate: Min - $137,300 | Max - $188,775

Pay: $137,300.00 - $188,775.00 per year

Apply Now

Refine Your Search

utilization management nurse jobs in los angeles, ca

RN Manager, Clinical Case Management - Full Time, Days

Registered Nurse Case Manager ED Full Time Nights

ECM Registered Nurse

Registered Nurse Manager - MLK BHC Residential

RN Case Manager - Case Management (ED) - Per Diem (12-hour night shifts) - Marina Hospital

Utilization Management Nurse Specialist RN II

Case Manager - Intensive Case Management, Hybrid/Remote

Registered Nurse - Utilization Management

Utilization Management Supervisor, Non-Clinical

Utilization Management Nurse

RN - Lead Care Manager (Full-Time, Day Shift)

RN - Lead Care Manager (Full-Time, Day Shift)

RN - Lead Care Manager (Full-Time, Day Shift)

RN - Lead Care Manager (Full-Time, Day Shift)

Registered Nurse - Utilization Review Case Manager - PER_DIEM - 8 Hour Days

Utilization Management Nurse, LVN/LPN (Part Time)

RN Nurse Utilization Review - Full Time, Days (Los Angeles)

Case Manager - RN - Case Management - Full Time 8 hour Days (Non-Exempt) (Union)

Utilization Management Admissions Liaison RN II

RN Case Manager - Case Management - Part time - Day Shift - Marina del Rey Hospital

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