Nursing Jobs in Bell Gardens, CA
$88,854 - $142,166 / year
Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Clinical Policy Nurse RN II is responsible for analytical research, trending, and assessment based on legislation, regulatory and accreditation requirements that impact claims, Utilization Management (UM) department and healthcare services policies. Reviews and analyzes clinical financial data to assess the effectiveness of existing and proposed policies to identify opportunities for improvement, cost containment, and quality enhancement. This position plays a key role in translating regulatory impacts into operational strategies and works collaboratively with internal and external stakeholders to ensure clinical policies support safe, effective, and compliant care delivery. Assists in development of policies and programs that improve health outcomes and target Fraud, Waste and Abuse (FWA). This position works cross functionally with other departments to develop end to end operational strategies of policy content and roll out timeframes. The Clinical Policy Nurse II serves as a liaison to ensure the ongoing maintenance of clinical coding for the authorization matrix.Duties Assess federal, state, and local legislation, regulatory guidance, and health care policies to identify potential impacts on clinical practice, reimbursement and organizational operations that impact healthcare services policies. Review and interpret clinical, utilization, and financial data to identify trends, opportunities for policy improvement and cost-savings. Research, develop, and evaluate clinical and health policy designed to improve patient outcomes, detect and mitigate Fraud, Waste, and Abuse (FWA), and streamline organizational processes. Monitor the implementation of health programs, clinical initiatives, and community action plans to assess effectiveness, compliance, and impact on patient outcomes. Collaborate with internal stakeholders to evaluate utilization trends and anomalies and contribute to policy development aimed at improving efficiency and compliance identified during risk assessments. Prepare analytical reports, summaries, and analyses assessing policy performance, regulatory impact, and communicate insights and recommendations to stakeholders to drive evidence-based policy and impacted outcomes. Present findings, recommendations, and action plans to key stakeholders. Participate in work groups related to healthcare services clinical policies and procedures including efforts to improve department processes, as needed. Perform other duties as assigned.Duties Continued Education Required Associate's Degree in NursingEducation Preferred Bachelor's Degree in NursingExperience Required: At least 5 years of experience in Clinical Nursing. At least 3 years of experience with Medi-Cal and Medicare in a managed care environment. Experience in performing and creating clinical documentation. Experience in regulatory compliance for a health plan. Preferred: Experience with active participation in state regulatory audits such as Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Centers for Medicare and Medicaid Services (CMS), and/or National Committee for Quality Assurance (NCQA) audits. At least 1 year of experience in clinical health services policies with a managed care plan. Skills Required: Demonstrated strong reporting skills by preparing clear, concise reports and presentations that communicate findings and performance. Working knowledge of clinical policies. Strong analytical and critical thinking skills with the ability to interpret regulatory requirements and legislation. Ability to translate regulatory requirements into auditable tools. Ability to perform independent research on complex medical topics. Excellent verbal and written communication skills. Strong problem solving and team building skills. Ability to work independently with strong self-direction. Advanced proficiency in Microsoft Word, Excel, and PDF documentation tools. Ability to work effectively with diverse teams in cross-functional work groups. Ability to multitask, re-prioritize tasking, and streamline day-to-day operations. Strong organizational and time-management skills. Preferred: Advanced skills in assessing clinical policy deficiencies through literature searching and clinical research analysis based on the best available evidence. Understanding of the managed care industry and market conditions. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California LicenseLicenses/Certifications Preferred Required Training Physical Requirements LightAdditional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO) 
$156,000 - $170,000 / year
Perioperative RN Manager Department: 7420-Operating Room Employment Type: Full Time Location: 14662 Newport Ave, Tustin, CA 92780 ("HOSPITAL") Reporting To: Glenda Luce Compensation: $156,000 - $170,000 / year Description About the Role Lead Surgical Excellence. Drive Patient Outcomes. Inspire High-Performing Teams. We are seeking an experienced and visionary Clinical Manager, Perioperative Services to provide operational leadership for our surgical services department. This nursing leadership role is responsible for, quality, financial stewardship, and clinical excellence of perioperative services, ensuring the delivery of safe, patient-centered care across all surgical settings. The Clinical manager serves as a leader within the organization, partnering with physicians, hospital leadership, and multidisciplinary teams to advance quality outcomes, patient safety initiatives, operational efficiency, and employee engagement. This leader will foster a culture of accountability, innovation, collaboration, and exceptional patient experiences while ensuring compliance with all regulatory and accreditation standards. Who We Are Serving Tustin, Santa Ana and other surrounding communities, Foothill Regional Medical Center is a fully accredited acute care hospital, licensed for 177 beds—120 beds for general acute care, 15 intensive care beds and 42 pediatric sub-acute beds. Our surgeons are supported by state-of-the-art robotics. Our Values Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team What You'll Do Provide 24/7 leadership and oversight for all perioperative services operations, clinical care delivery, staffing, quality, and financial performance. Ensure the delivery of high-quality, evidence-based patient care consistent with perioperative standards of practice. Develop and implement operational strategies that support organizational goals related to quality, patient safety, efficiency, and patient satisfaction. Maintain a highly reliable and compliant patient care delivery system that consistently achieves performance excellence. Lead quality improvement and performance excellence initiatives within surgical services. Ensure compliance with all applicable regulatory, accreditation, and professional standards, including state, federal, and governing agencies. Monitor key performance indicators and implement corrective action plans to drive continuous improvement. Champion patient safety initiatives and promote a culture of clinical excellence and accountability. Lead, develop, and mentor leaders and clinical staff to achieve individual and departmental goals. Oversee recruitment, hiring, onboarding, coaching, performance management, and employee engagement initiatives. Foster a positive workplace culture that promotes teamwork, professional development, retention, and accountability. Manage payroll processes and ensure appropriate staffing levels to support operational excellence. Build strong partnerships with surgeons, anesthesiologists, physicians, and hospital departments. Promote effective communication and collaboration across multidisciplinary teams. Serve as a key liaison to advance service line objectives and improve patient outcomes. Qualifications Active and unrestricted CA RN license At least two (2) years knowledge and progressive leadership experience within perioperative services, surgical services, operating room management, or related clinical settings. ACLS through American Heart Association Demonstrated success leading quality improvement, patient safety, operational excellence, and financial performance initiatives. Strong knowledge of perioperative standards, regulatory requirements, accreditation standards, and healthcare compliance. Proven ability to lead large teams, drive engagement, and influence organizational change. Preferred BSN Preferred CNOR Environmental Job Requirements and Working Conditions Our organization follows an in person work structure where the expectation is to work onsite on a weekly basis. The hospital is located at 14662 Newport Ave, Tustin, CA 92780. The total compensation target pay range for this role is $156,000.00 - $170,000.00 annually. The salary range represents our national target range for this role. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change. 
Schedule: 7:00PM-7:30AM Purpose Statement/Position Summary: The Care Partner provides patient and administrative support to Nursing staff as necessary. Duque 6 Rehab is a 22-bed rehabilitation unit. The Rehab program treats children with traumatic brain injury, spinal cord injury, rheumatologic disorders, anoxic brain insults, and cancer/blood disease patients. Minimum Qualifications/Work Experience: Able to write, speak fluently and understand English. 1+ year previous experience as a PCSA, Medical Assistant or Certified Nurse Assistant (CNA) preferred. Nursing Student Applicants: Completion of pediatric rotation preferred. Education/Licensure/Certifications: High School graduate or GED required. Current BLS card from the American Heart Association. 
