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LanceSoft is seeking a travel nurse RN Utilization Review for a travel nursing job in Duarte, California. Job Description & Requirements • Specialty: Utilization Review, • Discipline: RN, • Start Date: 10/20/2025, • Duration: 13 weeks, • 24 hours per week, • Shift: 12 hours, days, • Employment Type: Travel 2995607 Utilization Review RN position working two 12-hour day shifts each weekend (Saturday and Sunday). Responsibilities include case management and utilization review functions such as admission criteria, concurrent/continued stay reviews, prior authorizations, discharge planning, audits, appeals/denials, and medical necessity determinations using InterQual and Milliman criteria. Additional responsibilities include compliance with CMS, HIPAA, DRGs, CPT/ICD-10 coding, and NCQA/HEDIS standards. Provider support services include pharmacy, respiratory, PT, interpretation, phlebotomy, social services, and transportation. Business casual dress code.Ax Eligibility & Requirements\nRequirement\tDetails\nExperience\t3 years required\nTravel Experience\tYes, required\nCharge Experience\tPreferred\nEducation\tBSN required\nLicense\tCA RN license in hand upon submission (no EMSA, no pending)\nCertifications\tBLS required, CMC preferred\nCharting\tEpic required\nChemo Cert\tRequired for all RN roles (except phone triage & case management, but still encouraged)\nOrientation\t16 hours, non-billable\nPatient Ratio\t1:15 (review caseload, not direct care)\nAge Groups\tAdolescents, Adults, Pediatrics, Geriatrics\nWeekend Requirement\tYes, Sat/Sun shifts\nOT\tMust be approved daily by Charge RN with Nursing Staffing Office\nRTO\tAllowed, no restrictive rules\nLocals\tAccepted at reduced local rate (within 75 miles)\nFormer Employees\tNot eligible until cleared by facility\n\n\n#HCRR About LanceSoft Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization. Lancesoft Inc. is one of the highest rated companies in the industry. We have been recognized as one of the Largest Staffing firms and ranked in the top 50 fastest Growing Healthcare Staffing firms in 2022. Lancesoft offers short- and long-term contracts, permanent placements, and travel opportunities to credentialed and experienced professionals throughout the United States. We pride ourselves on having industry leading benefits. We understand the importance of partnering with an expert who values your needs, which is why we’re 100% committed to finding you an assignment that best matches your career and lifestyle goals. Our team of experienced career specialists takes the time to understand your needs and match you with the right job Lancesoft has been chosen by Staffing Industry Analysts as one of the Best Staffing Firms to Work for.LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities, Home Health & Community Health, Urgent Care Clinics, and many other provider-based facilities. Benefits • Weekly pay, • Medical benefits

Job Description QUALITY COMPLIANCE NURSE PURPOSE: The Quality and Compliance Nurse is responsible for working with the Medical Director, the VP of Clinical Policy, the QM Committee in developing, implementing, and refining the Quality Management Program. They are also responsible for oversight and management of Health Plan Audits, as well as responding to Appeals and Grievances. ESSENTIAL DUTIES: • Organizes and participates in QM Committee meetings. Prepares agenda and meeting minutes. Provides support functions necessary for effective QM Committee processes., • Helps in the development and maintenance of the QM Plan, annual work plan and quarterly reports in conjunction with the QM Committee., • In collaboration with VP of Clinical Policy and Client Health Services Department, identifies quality standards and clinical benchmarks., • As part of quarterly reporting, establishes QM processes through tracking and trending of data for identification of under and over utilization., • Coordinates QM functions between Medical Management Department, Physician Group, Health Plan and outpatient care settings assuring quality improvement in clinical care and non-clinical aspects of service., • Provides oversight and management of Health Plan audits including the preparation of all needed documents, • Timely review and processing of appeals and UM department grievances according to Medical Management policies and procedures., • Develops and monitors compliance with responses to corrective action plans (CAP) for post health plan audits and regulatory audits., • Acts as liaison to all affiliated health plans.Company DescriptionThrifty Management Services is the dedicated MSO for Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members. We work with the network’s participating physicians to coordinate patient care when a referral is made to a specialist or hospital for diagnosis and treatment. We coordinate patient care across all aspects of the provider network. We provide high quality services to its participating physicians and superior health care to its members.Thrifty Management Services is the dedicated MSO for Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members. We work with the network’s participating physicians to coordinate patient care when a referral is made to a specialist or hospital for diagnosis and treatment. We coordinate patient care across all aspects of the provider network. We provide high quality services to its participating physicians and superior health care to its members.

We're looking for candidates with great customer service skills to fill our Remote Customer Service role!.This role is entirely remote and offers full-time/Part time hours with flexibility.We are ready to schedule interviews for this week.We're seeking someone who is great with people, building rela

PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. Performs all essential functions under the direction

We're looking for candidates with great customer service skills to fill our Remote Customer Service role!.This role is entirely remote and offers full-time/Part time hours with flexibility.We are ready to schedule interviews for this week.We're seeking someone who is great with people, building rela

PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. Performs all essential functions under the direction

Registered Nurse License (California).

Posted job title: Registered Nurse:Registered Nurse,08:00:00-16:00:00. Prime Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Our extensive network of qualified candidates includes nurses, allied healthcare professionals, corporate support pr

Registered Nurse License (California).

GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Los Angeles, California. Job Title: Case Manager • Registered Nurse (RN) • Days. Posted job title: Registered Nurse (RN).

Registered Nurse License (California).

LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Fa

Registered Nurse License (California).

Host Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Downey, California.

Registered Nurse License (California).

Posted job title: Registered Nurse:Registered Nurse,08:00:00-16:00:00. Prime Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Our extensive network of qualified candidates includes nurses, allied healthcare professionals, corporate support pr

Registered Nurse License (California).

Tsubaki, OTOTO, and Camelia seek an organized Administrative Assistant to support our Managing Partner and Chef.The ideal candidate is detail-oriented, resourceful, and thrives in a fast-paced, team-oriented environment.Hospitality experience is a plus, as it helps provide context for working in a r

Registered Nurse License (California).

République, located in the heart of Los Angeles in the historic 1929 building originally constructed as Charlie Chaplin’s office, is led by husband-and-wife team Chef Walter Manzke and James Beard Award nominee Chef Margarita Manzke.Known for vibrant and diverse dining rooted in French

Registered Nurse License (California).

GHJ Search and Staffing serves as the recruitment division of GHJ, a prominent national accounting and advisory firm.Our team provides qualified Accounting and Finance professionals on a temporary and permanent basis across a broad range of industries.GHJ’s relationship with our Global Advisory an

Registered Nurse License (California).

Licensed Practical Nurse (LPN) - LPN-Licensed Practical Nurse. Licensed Practical Nurse (LPN).

Registered Nurse License (California).

The nurse will endeavor to facilitate engage & participate in coaching, training and Pl based initiatives that will elevate the day to day & emergency clinical care within the whole hospital. Minimum of one year experience as a staff nurse RN in an acute care hospital setting; E. Certified Emergency

Registered Nurse License (California).

Kaiser Permanente is seeking a Registered Nurse (RN) NICU - Neonatal Intensive Care for a nursing job in Downey, California. The Registered Nurse demonstrates proficiency by exhibiting the following skills, competencies, and behaviors:. Registered Nurse License (California).

The Registered Nurse is directly responsible for the care given to his/her assigned patients. Current and valid CA Registered Nurse License.

Current state licensure as Registered Nurse.

Case Management Nurses coordinate long-term care for their patients. As a Case Management Nurse, you’ll likely work with specific groups of patients.

Current state licensure as Registered Nurse.

Registered Nurse, RN, performs supervision of (VITAS employed and contracted) nursing tasks delegated to Hospice Aides, Licensed Practical/Vocational Nurses (and contracted Registered Nurses) and Volunteers per the plan of care. Registered Nurse, RN, appropriately delegates nursing tasks to Hospice

These nurses work in the critical care unit of a hospital or healthcare facility and look after patients who have experienced invasive surgery, accidents, trauma or organ failure.

As an integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients. The Registered Nurse is accountable for the coordination of patient care and education to the patient and family in accordance with the standards, policies, a

Case Management Nurses coordinate long-term care for their patients. As a Case Management Nurse, you’ll likely work with specific groups of patients.

Graduate of an accredited school of nursing with a current state license as a registered nurse. Registered Nurse (RN) at Agape Care Group summary:. As a Registered Nurse (RN) at Agape Care Group, you will provide compassionate care for patients and their families while evaluating their needs and cre

Join a supportive healthcare provider committed to connecting nurses with opportunities while fostering professional growth. Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Los Angeles, California. Some of the industry-leading benefits enjo

The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in the ICU. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. The Registered Nurse is respons

What do we do? Medical Solutions is one of the nation’s largest providers of total workforce solutions in the healthcare industry, connecting nurses and allied health clinicians with hospitals and healthcare systems across the country and around the corner. Travel Nurse, Utilization Review, Case M

Registered Nurse / LDRPN- RN at ScionHealth summary:. As a Registered Nurse in the Subacute Unit at ScionHealth, I provide critical care to chronic and medically complex patients through thorough assessment, planning, and intervention. Current state licensure as Registered Nurse.

Travel Nurse, Case Manager, Utilization Review, Healthcare Professional, Registered Nurse, Nursing Job, Los Angeles Nursing Jobs, Flexible Nursing Jobs, High Pay Traveling Nurse, Travel Nursing Benefits. Some of the industry-leading benefits enjoyed by Medical Solutions travel nurses and tra

These nurses work in the critical care unit of a hospital or healthcare facility and look after patients who have experienced invasive surgery, accidents, trauma or organ failure.

Travel Nurse, Healthcare, Case Manager, Utilization Review, Registered Nurse, Travel Nursing, Nursing Jobs, Healthcare Careers, Medical Solutions, Patient Care. What do we do? Medical Solutions is one of the nation’s largest providers of total workforce solutions in the healthcare industry, connec

These babies are born needing immediate medical attention, so Neonatal Intensive Care Nurses connect them to technology that helps them breathe and allows them to be fed intravenously, so they can gain weight. As a Neonatal Intensive Care Nurse, you’ll work under the direction of a physician, cari

Keck Medicine of USC is seeking a Registered Nurse (RN) Float for a nursing job in Alhambra, California. As an integral part of the interdisciplinary team, the Ambulatory Float Registered Nurse utilizes the nursing process to provide therapeutic care to patients. The Ambulatory Clinical Registered N

Current state licensure as Registered Nurse.

Keck Medicine of USC is seeking a Registered Nurse (RN) Day Surgery Supervisor for a nursing job in Los Angeles, California. Pref Certified Post Anesthesia Registered Nurse - CPAN (ASPAN) highly recommended within 1 year of hire. Pref Certified Ambulatory Perianessthesia Nurse - CAPA (ASPAN) highly