RN Jobs in Brea, CA

RN Telehealth Full-time
L.A. Care Health Plan

Clinical Policy Clinical Coder RN II

L.A. Care Health Plan Los Angeles, CA
$102,183 - $163,492 / year
Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (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 Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight. This position serves as a key clinical and coding resource, translating medical policy requirements into diagnosis, procedure, and service code logic, including determining which codes require prior authorization. Conducts in-depth research and analysis of legislation and regulatory requirements, clinical outcomes, utilization, claims, and financial data to identify utilization trends, fiscal risk, and opportunities for policy enhancement and cost containment. This position works cross-functionally with internal teams to ensure policies are codified, consistently applied, and monitored through reporting and data analysis. This position collaborates closely with internal stakeholders and external entities to support standardized benefit administration, effective program implementation, and organizational compliance with state, federal, and accreditation requirements. Duties Translate approved clinical policies and utilization management criteria into clear, codified claims rules and system logic to support accurate claims adjudication. Develop, revise, and recommend clinical policies and internal utilization management criteria when standard clinical guidelines are insufficient to support appropriate decision-making based on codified claim rules. Assess the downstream claims impact of new or revised clinical policies prior to implementation and recommend configuration updates to mitigate operational or financial risk. Participate in validation of claims configuration changes to ensure policies are applied correctly and consistently across all lines of business. Monitor post-implementation claims activity to identify configuration issues, unintended denials, or payment discrepancies related to clinical policy application. Support remediation of claims configuration defects by identifying root causes and coordinating corrective actions with internal teams. Participate in and lead specialty and cross-functional workgroups and committees focused on healthcare services clinical policies, utilization management processes, strategic initiatives, policy governance, operational alignment, and continuous improvement efforts. Ensure timely dissemination of accurate and consistent policies and procedures across departments. Promote collaboration, engagement, and a positive work environment while supporting departmental initiatives and team-based activities. Manage assigned projects from concept through implementation, ensuring timelines, quality standards, and deliverables are met. Analyze and interpret medical and utilization management policies to identify applicable diagnosis, procedure, and service codes and determine authorization, pre-payment, or post-payment review requirements. Define and maintain code lists that require prior authorization or other utilization management controls based on clinical evidence, regulatory guidance, utilization trends, and financial risk. Duties Continued Collaborate with internal teams to ensure authorization requirements and coding logic are accurately configured in authorization and claims systems based on authorization matrix requirements. Support accurate claims processing by validating codified authorization and policy requirements are correctly applied and aligned with approved medical policies. Provide clinical and coding recommendations to support the development, revision, and implementation of new or updated medical and utilization management policies. Investigate and resolve coding and authorization related issues, including claim denials, coding edits, authorization discrepancies, and policy interpretation questions. Review and assess claims edits, authorization matrixes, and coding rules to identify root causes of errors or inconsistencies and recommend corrective actions. Ensure coding, authorization requirements, and claims-related guidance align with medical necessity criteria, benefit structures, and applicable state, federal, and regulatory requirements. Develop, review, and maintain reporting related to authorization required codes, approval and denial rates, utilization patterns, claims payment outcomes, and policy effectiveness. Prepare reports, summaries, and presentations and communicate findings, recommendations, and action plans to internal and external stakeholders. Analyze claims, authorization, and utilization data to identify trends, measure policy impact, and recommend opportunities for policy refinement, cost containment, or reduction of administrative burden. Monitor post-implementation performance of authorization-required codes and recommend additions, removals, or modifications to authorization requirements based on regulatory thresholds and utilization outcomes. Perform other duties as assigned. Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 8 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. Experience with medical coding systems. Preferred: At least 1 year of experience in editing and writing clinical health services policies within a managed care health plan. Skills Required: Proficient with clinical policy through skills in literature searching and clinical research analysis based on the best available evidence. Working knowledge of clinical policies. Working knowledge of CPT/HCPC codes and claims. Ability to translate regulatory requirements into auditable tools. Ability to perform independent research on complex medical topics. Excellent verbal and written communication skills. Strong analytical, 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. Ability to identify discrepancies, assess risk, and recommend actionable solutions. Knowledge of medical coding systems, including ICD-10-CM, CPT, and HCPCS, and their application in authorization and claims environments. 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. Proficient in claims configuration, including claims adjudication workflows, configuration of claims edits and rules, and the translation of clinical and utilization management policies into system-based claims logic to support accurate, compliant payment outcomes. Understanding of the managed care industry and market conditions. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Professional Coder (CPC) Required Training Physical Requirements Light Additional 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)
RN Hospice Hospice Full-time
Silverado

Hospice RN Case Manager

Silverado Los Angeles, CA
$55 - $60 / hour
Join Silverado Hospice LA covering our Torrance and surrounding areas and be part of a nationally recognized team ranked in the top 10 nationwide by Fortune Magazine’s Best Workplaces in Aging Services™ . Since 1997, Silverado has been delivering exceptional care to individuals with neurodegenerative conditions and those facing life-limiting illnesses through our Hospice services. We’re a certified Great Place to Work® and proud to offer competitive pay, benefits, and growth opportunities. We’re hiring a RN Case Manager – a compassionate and skilled clinician who coordinates care, develops individualized plans, and provides hands-on hospice and palliative care for patients and families. This role is essential to ensuring quality care and supporting patients throughout their end-of-life journey. Be a Difference-Maker with a Hospice Care Leader You lead with clinical expertise, empathy, and strong organizational skills. You thrive in a mission-driven environment and are passionate about guiding patients and families with dignity and compassion. What You’ll Be Doing Develop detailed Plans of Care for assigned patients, ensuring all services are identified and met Collaborate with the Interdisciplinary Group, patient, family, and attending physician to coordinate care Provide skilled hospice and palliative care for the remainder of the patient’s life Conduct comprehensive nursing evaluations and assessments Provide field supervision to LVNs and Home Health Aides assigned to your patients Perform field case management and other duties assigned Qualifications Registered Nurse with a valid state license Minimum of 1 year experience as an RN required; hospice experience preferred Ability to lift up to 50 pounds Must clear criminal background check, physical, and drug screening Valid driver’s license, good driving record, and reliable transportation required Willingness to drive to patient locations and work outside regular hours as needed Why Choose Silverado? Fortune Magazine Best Workplace in Aging Services™ Certified Great Place to Work® Strong internal mobility Shift Schedule: Full Time, AM shift, Monday - Friday, 8:00 AM - 5:00 PM Anticipated pay range: $55 USD - $60 USD Silverado offers the following benefits to eligible employees: 401(k) matching Health, Dental and Vision Insurance Flexible Spending Account (FSA) Paid time off Tuition reimbursement and professional development assistance Referral program Other amazing benefits such as Pet Insurance, Auto and Home Insurance and Discount Programs! * Silverado does not accept candidates from outside recruiters or agencies for this role. * California Employees: For roles requiring driving, the driving requirement has been deemed essential to the performance of this role due to specific business necessity. Supporting documentation is maintained by Silverado and is available for review upon request to ensure compliance with California law. To view California Consumer Privacy Act (CCPA) information, please visit this page: https://www.silverado.com/legal-disclaimers/#Consumer-Privacy-Act-Disclosure Employment offers are contingent on background check, drug screening, physical, and TB testing (if applicable). Silverado uses E-Verify to confirm work authorization with both the Social Security Administration and the Department of Homeland Security EOE/M/F/D/V
RN Manager/Supervisor Full-time
UCI Health

Assistant RN Manager - Periop Services - Lakewood - FT Days

UCI Health Lakewood, CA
Who We Are UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. To learn more about UCI Health, visit www.ucihealth.org. Your Role on the Team Position Summary The Assistant Nurse Manager, Perioperative Services supports in the day-to-day clinical operations, staff management, and quality oversight of perioperative services within an assigned facility or defined service area. The incumbent assists in directing the activities of perioperative coworkers ensuring that all patient care activities are delivered safely, efficiently, and in accordance with established clinical standards, regulatory requirements, and departmental policies and procedures. This role shares accountability for staffing and scheduling coordination, staff competency, daily workflow management, supply and resource utilization, and the maintenance of a safe and therapeutic surgical environment. The Assistant Nurse Manager assists in the onboarding and orientation of new staff, supports the performance evaluation process, provides ongoing coaching and mentorship to frontline coworkers. The incumbent contributes to performance improvement initiatives, participates in quality and safety reviews, and helps implement departmental goals and operational changes as directed. This position works under direction and oversight and exercises sound independent judgment in managing unit-level operational and clinical issues within the assigned perioperative area. Required Qualifications What It Takes to be Successful Prior management/leadership experience in an acute care setting Must demonstrate excellent customer service skills Minimum of 1 year experience in Perioperative Services, preferably the Operating Room Knowledge of Title 22 and Joint Commission Requirements Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload Ability to establish and maintain effective working relationships across the Health System Licenses And Certifications Registered Nurse Basic Life Support Education Bachelor of Science, Nursing MASTER OF SCIENCE IN NURSING Total Rewards We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits. Conditions Of Employment The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment: Background Check and Live Scan Employment Misconduct* Legal Right to Work in the United States Vaccination Policies Smoking and Tobacco Policy Drug Free Environment Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements. California Child Abuse and Neglect Reporting Act E-Verify Pre-Placement Health Evaluation Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php Closing Statement The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy. We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming. UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m. Consideration for Work Authorization Sponsorship Must be able to provide proof of work authorization
RN Manager/Supervisor Full-time
Adventist Health

Manager, RN - Surgery (Full Time, Day Shift)

Adventist Health Los Angeles, CA
Job Description Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital, three medical office buildings, residency programs, comprehensive cancer care and a vast scope of services located in the Los Angeles area. In 2019, Adventist Health White Memorial was recognized with the Malcolm Baldrige National Quality Award, the nation's highest presidential honor for performance excellence. We are proud to promote wellness in the community at the local farmers market and through our community resource center with services for seniors and Spanish-speakers. Los Angeles is known for its art, rich culture, numerous sports teams and world-renowned dining. There is something for everyone in this culturally diverse city. Job Summary Creates an environment where front line nurses and ancillary staff provide whole person care that is safe, complication free, and optimizes functional independence for each patient. Maintains a highly-visible presence on the unit. Collaborates closely with staff, charge nurses, physicians, and other department leaders to ensure that clinical operations are efficient and effective, and achieve high patient/family/staff satisfaction. Supervises and directs the activities of various levels of assigned nursing and ancillary personnel utilizing both professional and supervisory discretion and independent judgment.Schedules, leads, and coordinates the daily activities of a defined unit on an assigned shift. Assists leadership in accomplishing unit and organizational goals. Job Requirements Education and Work Experience: Bachelor’s Degree in nursing or equivalent combination of education/related experience: Required Master's Degree: Preferred Five years' technical experience: Preferred One year's leadership experience: Preferred Two years' experience of acute care nursing in hospital setting: Preferred Licenses/Certifications Registered Nurse (RN) licensure in the state of practice: Required Cardiopulmonary Resuscitation (CPR) certification or Basic Life Support (BLS OR HS-BLS OR RQIBLS) certification from approved vendor per AH policy: Preferred National specialty certification in area of expertise or in nursing administration: Preferred Facility Specific License/Certifications Basic Life Support (BLS OR HS-BLS OR RQI BLS) certification: Required Hospital Fire and Life Safety (HLFS): Required Essential Functions Builds a high performing clinical work team by recruiting and retaining skilled professional staff. Builds a strong infrastructure with designated charge nurses and unit champions. Engages staff in developing action plans for needed change to create safe, desired outcomes. Completes periodic evaluations of personnel supervised. Coaches and disciplines personnel when deems appropriate. Monitors attendance. Works closely with staff, unit champions, and the clinical educator to identify and meet educational needs. Uses consistent exercise of discretion and judgment. Sets and strives to achieve goals for patient safety, quality of care and compliance with regulatory requirements. Creates a culture of open communication. Develops strategies to improve patient/family, and physician satisfaction. Establishes standards of care for professional nursing practice that staff are held accountable to. Monitors critical processes and outcomes of care through audits, analysis of data, and complaints or incident reports. Exercises discretion and independent judgment with respect to matters of significance, evaluating and comparing possible courses-of-action, and making decisions/recommendations after considering the various possibilities. Conducts daily rounds with physicians and other staff and actively communicates, as needed, to coordinate appropriate care for patients and families. Directs/monitors personnel in the performance of patient care activities in order to ensure adequate patient care and quality of work. Investigates and resolves patient care and operational issues, as needed. Initiates and coordinates individual and team conferences with health team members, patients, and/or families to initiate and revise care plans for optimal, individualized patient care as per care setting. Assesses the personnel requirements of the unit on a daily basis and requests additional personnel when determines they are necessary. Authorizes and assigns overtime to personnel when independently determines this to be appropriate. Completes monthly unit staff schedule on time, accurately, and in collaboration with staff members and management with minimal incidents of absence or unbalanced/short staffing events. Facilitates throughput through early discharge of patients, pull-ahead beds, and timely admission/transfer of patients and forecasting admission. Works with facility services to assure that the department and equipment is maintained to be safe and operational. Prevents complications of care including nosocomial infections. Conducts emergency preparedness reviews. Performs other job-related duties as assigned. Organizational Requirements Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein. About Us Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.
RN Telehealth Full-time
L.A. Care Health Plan

Clinical Policy Nurse RN II

L.A. Care Health Plan Los Angeles, 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 Nursing Education Preferred Bachelor's Degree in Nursing Experience 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 License Licenses/Certifications Preferred Required Training Physical Requirements Light Additional 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)
RN Utilization Review Telehealth Full-time
L.A. Care Health Plan

Utilization Management Claims Review Nurse RN II

L.A. Care Health Plan Los Angeles, 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 Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of medical claims to ensure services were medically necessary, appropriately documented, accurately billed, and compliant with established clinical policies and regulatory standards. This position supports payment integrity initiatives through retrospective and pre-payment review processes, helps reduce unnecessary denials, and monitors for potential fraud, waste, and abuse (FWA). The UM Claims Review Nurse RN II collaborates closely with internal teams to ensure accurate adjudication and compliance. This position collaborates closely with internal stakeholders and external entities to support compliance with state, federal, and accreditation requirements. Duties Perform claims pre-payment review by supporting the Claims team in evaluating flagged claims prior to adjudication to ensure services are medically necessary, documentation supports billed services, coding is accurate and aligned with authorization when applicable, and unnecessary denials are reduced through accurate clinical validation. Conduct comprehensive retrospective reviews, applying established clinical criteria, policies, and regulatory guidelines to determine medical necessity and appropriateness of services rendered. Complete Provider Dispute Review (PDR) clinical evaluations for disputed claims requiring medical necessity scrutiny and clinical determination. Apply internal and external clinical policies, including those developed by the Clinical Policy team, to ensure compliance with guidelines intended to limit fraud, waste, and abuse (FWA). Ensure adherence to federal and state regulations, and accreditation standards. Monitor trends related to contested claims and identify potential FWA concerns; escalate findings in accordance with organizational compliance protocols. Collaborate with internal teams to support payment integrity initiatives. Provide clear, well-documented clinical rationales supporting approval, denial, or adjustment decisions. Maintain productivity and quality standards consistent with departmental expectations. Participate in audits, regulatory readiness activities, and quality improvement initiatives as assigned. Document review outcomes clearly and accurately within designated systems, ensuring audit readiness and traceability. Remain current with evolving clinical guidelines, coding standards, reimbursement methodologies, and regulatory requirements. Perform other duties as assigned. Duties Continued Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience 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 Provider Dispute Review (PDR) processes. Experience applying clinical guidelines (e.g., InterQual, MCG, or internally developed criteria) in processes. Prior experience in payment integrity, compliance, or fraud, waste, and abuse (FWA) monitoring. Skills Required: Knowledge of medical necessity criteria, reimbursement principles, and managed care operation. Working knowledge of clinical policies. Working knowledge of CPT/HCPC Codes, and ICD-10. Proficient in claims processing systems and electronic medical record platforms. Strong problem-solving skills and the ability to identify discrepancies, assess risk, and recommend actionable solutions. Strong verbal and written communication skills. Ability to work independently with a high degree of initiative, organization, and self-direction. Ability to work effectively with diverse teams in cross-functional work groups. Ability to multitask, re-prioritize tasking, and streamline day-to-day operations. Familiarity with regulatory and accreditation standards (e.g., CMS, Medi-Cal, NCQA). Understanding of the managed care industry and market conditions. High organizational and time-management skills. Preferred: Strong analytical and investigative skills with the ability to synthesize clinical and claims information into clear, defensible determinations are highly valued. Advanced knowledge of medical necessity criteria tools such as InterQual or MCG. Extensive knowledge in claims reviews includes retrospective reviews, pre-payment claims review, and medical necessity determinations. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Required Training Physical Requirements Light Additional 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)
RN Other
Sevita

Registered Nurse

Sevita La Habra, CA
NeuroRestorative, a part of the Sevita family, provides rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges. In a variety of locations and community-based settings, we offer a range of programs, including vocational and therapy programs, day treatments, and specialized services for infants, children, adolescents, Military Service Members and Veterans. Registered Nurse Per-diem DAY & NOC (must be available for both DAY & NOC) DAY shift: 7:00 AM to 7:30 PM NOC shift: 7:00 PM to 7:30 AM 12-hour shifts (every shift includes 4 hours of overtime pay) Salary range: $38.00-$41.50 per hour, based on experience NOC shift = $2.00 per hour shift differential Blended salary range (base pay + overtime pay): $44.00-$48.42 per hour La Habra, CA NeuroRestorative facility located on Avocado Crest Rd. CLHF (Congregate Living Health Facility) 10-bed facility Low patient ratios On demand pay via Dayforce Wallet Rewarding work, impacting the lives of those you serve, working alongside a great team of coworkers Qualifications Current state RN License Current CPR certification Minimum 1 year of experience Excellent assessment skills with the ability to exercise critical thinking in the clinical environment Effective communication skills – ability to communicate with team members, medical professionals, those we serve, and their families A reliable, responsible attitude and a compassionate approach A commitment to quality in everything you do EVERY PERSON DESERVES A FULFILLING CAREER Clinical Settings : Opportunities to explore different specialties and settings of care — disabilities, brain injury, substance abuse disorder, and more Learning & Development : We invest in your professional growth through continuing education, training, and more Relationship-Based Environment : Supportive relationships with coworkers and supervisors who help you grow and learn Come join our amazing team of committed and caring professionals. Apply Today! Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S. As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.
RN OB/GYN Outpatient Part-time
UCI Health

Clinical Nurse II - Manchester OBGYN - P/T

UCI Health Orange, CA
Who We Are UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. To learn more about UCI Health, visit www.ucihealth.org. Your Role on the Team Position Summary Incumbent provides care to an assigned group of patients focusing on meeting the clinical needs of the patient. Performs professional nursing duties that incorporate the psychomotor and age appropriate cognitive skills of the patient/family/significant other to assess, plan, intervene and advocate for the patient. Will evaluate patient outcomes and effectiveness of plan of care. Serves as a role model to the clinic staff. Assists in developing patient education for the assigned clinic. Required Qualifications What It Takes to be Successful Must possess the skill, knowledge and ability essential to the successful performance of assigned duties Must demonstrate customer service skills appropriate to the job Minimum of 6 months demonstrated nursing experience in an acute care or ambulatory care setting Current California RN license All external candidates must have a Bachelor of Science in Nursing Ability to work variable shifts including evenings, nights, weekends, and holidays Ability to read, write and communicate effectively in English Ability to maintain flexibility and work well in a constantly changing environment Ability to maintain a work pace appropriate to the workload Ability to establish and maintain effective working relationships across the Health System Preferred Qualifications Understanding of JCAHO requirements Knowledge of University and medical center organizations, policies, procedures and forms Current ACLS certification Bilingual skills to communicate effectively with patients and families Licenses And Certifications Basic Life Support Education Total Rewards We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits. Conditions Of Employment The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment: Background Check and Live Scan Employment Misconduct* Legal Right to Work in the United States Vaccination Policies Smoking and Tobacco Policy Drug Free Environment Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements. California Child Abuse and Neglect Reporting Act E-Verify Pre-Placement Health Evaluation Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php Closing Statement The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy. We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming. UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m. Consideration for Work Authorization Sponsorship Must be able to provide proof of work authorization
RN Telehealth Full-time
L.A. Care Health Plan

Delegation Oversight Clinical Auditor RN II

L.A. Care Health Plan Los Angeles, 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 Delegation Oversight Clinical Auditor RN II is responsible for ensuring that delegates contracted to perform Utilization Management (UM) functions on behalf of L.A. Care (LAC) is in compliance with all UM regulatory requirements and new legislation through the maintenance of required policies/procedures/workflows/ processes/audit tools necessary to meet the requirements. This position utilizes a rapid team approach for needed improvements identified through external audits of delegated entities. This position assist in maintaining continuous quality improvement in the Delegation Oversight Clinical Audit unit ensuring that departmental/divisional and organizational goals are accomplished through overseeing and facilitating compliance of the Plan Partners, Participating Provider Groups (PPG), Specialty Health Plans (SHP), and contracted provider network as managed by the Delegation Oversight Department. This position is responsible, as part of the oversight team, for ensuring compliance of the Plan Partners and/or Participating Physician Groups (PPG) to regulatory, contractual and L.A. Care requirements. This position is responsible for performing annual and focused audits. This position also acts as a liaison between the Plan Partners and PPGs and L.A. Care Health Plan regarding UM issues. The position assists in improving access and utilization performance of Plan Partners and PPGs by being a resource for best practices and providing continuous feedback. Additionally, the oversight responsibility of this position includes reporting to management and providing consultation/instructional/coaching recommendations to improve overall compliance of Plan Partners and PPGs with all regulations and standards. Duties Continually ensures delegate compliance with UM Policies/Procedures, Letter Templates, Workflows, Processes, and Audit Tools in compliance with all regulatory requirements/new legislation. Works collaboratively with Regulatory Affairs & Compliance. Stay abreast of new UM legislation, regulations, or other changes impacting UM in order to put processes in place for compliance. Prepares the Delegation Oversight Clinical Audit team for internal audits and for conducting PP/PPG audits, developing mechanisms for tracking/ trending of progress for --UM/PPG (internal) and PP (external) for compliance with UM standards, and identities system/individual areas for improvement through these processes. Prepares the Delegation Oversight Department for review by external regulatory bodies. Ensures that the Delegation Oversight Department is continually prepared for external review with staff daily work conducted in a manner that meets regulatory requirements. Ensures that the Delegation Oversight Clinical Audit unit functions as a team in preparing needed documents for an external review. Completes annual, focused and periodic audit activities timely and thoroughly including identification of deficiencies, response to mitigation, review and response to CAPs. Identifies repeat deficiencies. Assures audit documentation is clear, complete and accurate. Completes periodic monitoring of PP or PPG performance in critical deficiency areas. Completes follow-up audits and related reports and recommendations. Identifies options to assist PP or PPGs with continued or significant deficiencies. Updates audit tools to meet regulatory, contractual and L.A. Care requirements. Develops and conducts ongoing monitoring activities including but not limited to file reviews and letters and supplemental reports. Present summary results to L.A. Care's UM Committee. Communicates with assigned PP and PPGs on an ongoing basis. Develop mechanism to track and trend progress of PP and PPG's compliance to UM standards and identify system wide issues. Maintains confidentiality in compliance with all Health Insurance Portability and Accountability Act (HIPAA) requirements. Assists co-workers with special projects or work volume as required. Actively identifies and implements efforts to improve the quality, effectiveness and efficiency of job functions. Actively identifies and makes recommendations to supervisor ideas to improve the quality effectiveness and efficiency of departmental and health services functions. Communicates to supervisors any barriers to completing assignments or daily work in an efficient and effective manner. Duties Continued Provides training, education and consultation as necessary to PP and PPGs. Collaborates with other Clinical Auditors on identifying topics and developing agendas for the JOM's and PP visits/communication. Develops and implements procedures to assure compliance with care coordination and documentation of linked and carved out services. Conducts Interrater Reliability Testing (referral management and oversight) for new staff/physicians and annually or as needed for existing staff/physicians. Works with other departments as necessary to facilitate teamwork for creating and/or improving interdepartmental processes to meet regulatory requirements. Clinical Auditor (Performance Monitoring): In addition to the responsibilities above, the Clinical Auditor (Performance Monitoring) position ensures compliance of the delegates (Participating Physician Groups, Plan Partners and Vendors) with regulatory, contractual and L.A. Care business requirements. This position is responsible for delegation oversight continuous monitoring activities and monitoring corrective action plans from the annual and focused audits. The position also acts as a liaison between the Plan Partners, PPGs and Vendors regarding Utilization Management (UM) issues; assists in improving access and utilization performance of PPGs by being a resource for best practice and providing continuous performance feedback. Additionally, the oversight responsibility of this position includes attendance at UM Committee, Delegation Oversight Committee, Sanctions Committee, Internal Compliance Committee, and Joint Operation Meetings. It includes monitoring supplemental UM reports, reporting to management as well as consultation/coaching/instructional activities to improve overall compliance with all regulations and standards. Clinical Auditor (Behavioral Health): In addition to the duties above, the Clinical Auditor (Behavioral Health) designs an audit program specific to ensuring delegates are meeting behavioral health regulatory requirements. This ensures Specialty Health Plans and Plan Partners are in compliance with regulatory, contractual, and L.A. Care business requirements. This position is responsible for developing and maintaining annual audit tools, policy requirements specific to delegates, and a monitoring program to continually receive and aggregate Behavioral Health specific performance requirements. The position acts as a liaison between Specialty Health Plans and Plan Partners regarding Behavioral Health issues, assists in improving access and Behavioral Health performance by being a resource for best practice and providing continuous performance feedback. Additionally, the oversight responsibility includes liasing with internal Behavioral Health units, the Medical Director of Behavioral Health, attendance at UM Committee, Delegation Oversight Committee, Sanctions Committee, Internal Compliance Committee, and Joint Operation Meetings. It includes monitoring supplemental UM reports, reporting to management as well as consultation/coaching/instructional activities to improve overall compliance with all regulations and standards. Performs other duties as assigned. Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 7 years in a clinical setting with at least 3 years in a managed care setting in Utilization Management/Case Management. Skills Required: Knowledge of issues pertaining to Medi-Cal and other HMO & IPA contracts, & payers. Ability to manage and organize large volumes of data. Knowledge of accreditation entities and their requirements. Excellent verbal and written communication skills and excellent interpersonal skills. Good working knowledge of regulatory requirements/standards. Ability to work independently. Ability to solve complex issues and identify creative solutions. Computer ease & literacy with Word, Excel, PowerPoint Skills. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Required Training Physical Requirements Light Additional 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)
RN Educator Full-time
PIH Health

RN Clinical Educator/ Clinical Nurse Specialist, Perioperative Services, Education, Full time, Days

PIH Health Whittier, CA
$111,696 - $184,080 / year
The Registered Nurse (RN) Clinical Educator educates staff to competence according to standards, regulations, and best practice using a variety of teaching methods. Facilitates achievement of staff role clarity, professional role confidence, and proficiency. Operates as a change agent in the practice and learning environment. PIH Health is a nonprofit, regional healthcare network that serves approximately 3.7 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 35 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. PIH Health is also certified as a Great Place to Work ® . For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Nursing and education theory knowledge Refined written and verbal communication. Current knowledge of trends in nursing practice Clinical competence Ability to plan, organize, implement, and evaluate Customer service and conflict resolution skills Computer skills Familiar teaching methods and audiovisual equipment Ability to operate independently With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational, and environmental needs of patient/significant-other when administering care Required Experience Required: BSN Current California RN License BLS, ACLS certifications Minimum three years clinical experience in acute care OR setting Preferred: MSN preferred. CNS certification Address 12401 Washington Blvd. Salary 111696.00-184080.00 Shift Days Zip Code 90602
RN Labor and Delivery Full-time
UCI Health

Per Diem Nurse - Labor and Delivery - Days - Orange

UCI Health Orange, CA
Who We Are UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. To learn more about UCI Health, visit www.ucihealth.org. Your Role on the Team Position Summary The clinical nurse will collaborate with interdisciplinary teams to develop and implement a plan of care for a specific group of assigned patients. Performs professional nursing duties that incorporate the psychomotor and age appropriate cognitive skills of the patient/family/significant other to assess, plan, intervene and advocate for the patient on an ongoing basis throughout the continuum of care. Will evaluate patient outcomes, effectiveness of plan of care, and readiness for discharge and revise plan or make referrals as necessary. Acts as a role model and mentor to a variety of students and nurses new to the unit. Functions as a (PCC) Patient Care Coordinator as requested by the supervisor/manager. Required Qualifications What It Takes to be Successful Minimum of one (1) year of experience working as an RN in Labor & Delivery. Ability to work variable shifts including evenings, nights, weekends, and holidays Ability to read, write and communicate effectively in English Ability to maintain flexibility and work well in a fast paced, constantly changing environment Ability to maintain a work pace appropriate to the workload AWHONN Advanced Fetal Monitoring completed within the last two (2) years. Preferred Qualifications Understanding of applicable regulatory requirements Bilingual skills to communicate effectively with patients and families Licenses And Certifications Registered Nurse Neonatal Resuscitation Program Basic Life Support Advanced Cardiac Life Support Education Bachelor of Science, Nursing Total Rewards We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits. Conditions Of Employment The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment: Background Check and Live Scan Employment Misconduct* Legal Right to Work in the United States Vaccination Policies Smoking and Tobacco Policy Drug Free Environment Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements. California Child Abuse and Neglect Reporting Act E-Verify Pre-Placement Health Evaluation Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php Closing Statement The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy. We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming. UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m. Consideration for Work Authorization Sponsorship Must be able to provide proof of work authorization
RN ICU Full-time
PIH Health

Registered Nurse (RN), Critical Care, Full time, 7pm-7:30am

PIH Health Whittier, CA
$50.50 - $84.25 / hour
Provides direct nursing care including assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of patient care as well as coordinates the delivery of care provided by other care team members and disciplines. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Written and verbal communications, interpersonal skills. Basic organizational skills. Basic computer skills. Demonstrated leadership abilities. Patient assessment. Clinical education related to specialty. Principles of patient/family teaching. Required Experience Current California RN license Evidence of continuing education Current experience in an acute care facility Current Basic Life Support Card Basic EKG interpretation required Current ACLS certification required Current NIHSS certificate Critical Care Course preferred ICU experience preferred Address 12401 Washington Blvd. Salary 50.50-84.25 Shift Nights Shift Differential 7.00 Zip Code 90602
RN ICU Full-time
Prime Healthcare

Registered Nurse, RN - ICU

Prime Healthcare Lynwood, CA
$50.11 - $67.36 / hour
Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of diagnostic and treatment services in specialties including Cardiovascular, Surgical, Orthopedics, Obstetrics, Pediatrics, Behavioral Health, and Emergency and Trauma Care. In addition, the hospital offers a broad array of education and outreach programs that advance community health. St. Francis Medical Center is a Comprehensive Stroke Center, STEMI Receiving Center, ED Approved for Pediatrics, Geriatric ED, Level III Neonatal ICU, and Level II Trauma Center. Please visit www.stfrancismedicalcenter.com for more information. Join an award-winning team of dedicated professionals committed to compassion, quality, and service! Responsibilities The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. 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. They communicate with the physician about changes in the patient’s clinical condition including hemodynamic monitoring, results of diagnostic studies and abnormal results and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment. Maintains patient privacy and confidentiality. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Current and valid state RN License.2. Current BLS certificate upon hire and maintain current.3. Completion of Critical Care Course preferred. 4. Basic Arrythmia Interpretation within 30 days of hire.5. Current ACLS certificate 30 days upon hire and maintain current. 6. Minimum of one year as a staff RN in acute care hospital, critical care preferred.7. Critical Care RN (CCRN) Certification preferred. 8. Bachelor of Science in Nursing (BSN) preferred. Pay Transparency St. Francis Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. The current compensation range for this role is $50.11 to $67.36. 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. Employment Status Full Time Shift Nights Equal Employment Opportunity Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Privacy Notice Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf
RN Utilization Review Telehealth Full-time
L.A. Care Health Plan

Utilization Management Clinical Quality Nurse Reviewer RN II

L.A. Care Health Plan Los Angeles, 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 Utilization Management Clinical Quality Nurse Reviewer RN II, under the purview of the Utilization Management (UM) Department Leadership Team, is responsible for conducting and tracking targeted and random internal department documentation audits. This role ensures that UM practices and supporting documentation are compliant with all regulatory requirements. The Incumbent also serves as a Subject Matter Expert during external audits as well as leads pre- and post-audit preparation/follow-up. This position actively participates in the development and review of policies and procedures to certify compliance with regulatory guidelines and mandates. This position focuses on UM cases for all lines of business to identify areas of opportunity for increasing positive audit outcomes and improved service to L.A. Care’s membership. This position is responsible for identifying and monitoring staff (non-clinical, nurse, and physician) performance against key performance indicator trends that warrant recognition or remediation. This position performs data mining and analysis and creates reports on audit findings, as well as makes recommendations, to submit to the department's Quality Assurance Team and UM Management. Duties Facilitates the development, review, and revision of organizational and departmental process flows to ensure compliance with relevant regulatory, organizational, and departmental guidelines. Keenly focuses on practices and documentation of clinical staff, serving as a resource on state and federal industry mandates applicable to UM functions. Generates results of findings, enhances, and analyzes various reports related, but not limited to, quality and accuracy of case documentation. Works with department leadership to assess for all opportunities related to quality improvements. Compiles and presents quality report cards that measure adherence to quality and regulatory compliance. Keeps UM Leadership apprised of departmental and industry trends, deficiencies, and any potential risks, and collaborates with the team to develop and execute mitigation efforts. Serves as a consultant to the organization's Compliance team on an ad hoc basis. Performs other duties as assigned. Duties Continued Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree Master's Degree in Nursing Experience Required: At least 5 years of experience in Clinical Nursing. Minimum of 2 years of auditing clinical documentation. Active participation in at least two state regulatory audits and one federal regulatory audits. Previous experience with Medi-Cal and Medicare in a managed care environment and experience with mitigation planning and implementation. Preferred: Experience performing clinical documentation for a health plan. Active participation in at least three state regulatory audits, at least one National Committee for Quality Assurance (NCQA) audit and/or Centers for Medicare and Medicaid Services (CMS) audit. Background in teaching and/or clinical education. Skills Required: Superior verbal and written communication skills. Advanced computer proficiency in both Microsoft Word and Excel. Strong analytical and team building skills. Ability to work independently and be self-directed. Ability to work effectively with diverse team members. Strong problem-solving skills. Ability to multitask and streamline day-to-day operations. Ability to translate regulatory requirements into auditable tools. Preferred: Proven ability to lead successful performance improvement projects. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Required Training Physical Requirements Light Additional 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)
RN ICU Full-time
PIH Health

Registered Nurse (RN), Critical Care, Full time, 7pm-7:30am

PIH Health Whittier, CA
$50.50 - $84.25 / hour
Provides direct nursing care including assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of patient care as well as coordinates the delivery of care provided by other care team members and disciplines. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Written and verbal communications, interpersonal skills. Basic organizational skills. Basic computer skills. Demonstrated leadership abilities. Patient assessment. Clinical education related to specialty. Principles of patient/family teaching. Required Experience Current California RN license Evidence of continuing education Current experience in an acute care facility Current Basic Life Support Card Basic EKG interpretation required Current ACLS certification required NIHSS required Critical Care Course preferred Preferred ICU experience Address 12401 Washington Blvd. Salary 50.50-84.25 Shift Days Zip Code 90602
RN Telehealth Full-time
L.A. Care Health Plan

Appeals and Grievances Nurse Specialist RN II

L.A. Care Health Plan Los Angeles, 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 Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct assistance to members with health care access or benefit coordination issues, ensuring that clinical grievances, complaints and complex issues are investigated and resolved to the member's satisfaction in a manner consistent with L.A. Care, Centers of Medicare and Medicaid Services (CMS) and regulatory guidelines. Benefit coordination may involve coordinating multiple L.A. Care products, Fee for services (FFS) Medi-Cal/Medicare, or commercial insurance. Duties Conducts intake/triage and appropriate classification of Clinical A&G, and Pharmacy requests and makes accurate judgment on appeal, grievance, Provider Claim Disputes, medical records or other issues and follows procedures on how to handle each type of request and route to the appropriate area within the department. Investigation, and resolution of clinical member complaints (grievances/appeals) utilizing all regulatory requirements. Investigation, and resolution of clinical Provider Complaints/ Provider Data Resolution (PDR) (grievances/appeals) utilizing regulatory and internal guidelines and Service Level Agreement (SLA). Identification of Expedited Cases and resolution within 72 hours. Works with the external providers and Participating Physician Group's (PPG) representatives to obtain relevant medical records and communication documentation. Prepares resolved complaint files for Centers for Medicare and Medicaid Services (CMS), DMHC, and external review organization (QIO or IRE). Process the case thru to effectuation and final case documentation in the A&G system of record. Investigation and preparation of State Fair Hearing cases as assigned. Prepares resolved complaint files for CMS external review organization - Quality Improvement Organization (QIO) or Independent Review Entity (IRE). Conducts reviews and presents to physicians, provider disputes which would be based on medical necessity reviews. Prepares authorizations, after approval by the Medical Director. When necessary, outreaches to providers, vendors, hospitals, and members to request necessary information or to provide case status and/or next steps. In instances where necessary, sends written notifications to appropriate parties. All interactions including verbal outreach and written communication will be documented in the A&G system of record. Participates inter-rater reliability training and assessments. Perform other duties as assigned. Duties Continued Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 5 years of experience in Clinical RN. At least 2 years in Medicare/ Medicaid in a managed care/ health plan environment. Skills Required: Excellent interpersonal and communication skills. Computer literacy and adaptability to computer learning. Time management and priority setting skills. Must be organized and a team player Able to work effectively with various internal departments/service areas, L.A. Care's plan partners, participating provider groups, and other external agencies. Good working knowledge of regulatory requirements/standards. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information This position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations and work on-call. This position requires handling various caseloads and flexibility to adapt to changing priorities which may include but not limited to redistributed work assignments, team projects, and other priorities as assigned 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)
RN NICU Full-time
PIH Health

Registered Nurse (RN), NICU, Full time, 7pm-7:30am

PIH Health Whittier, CA
$50.50 - $84.25 / hour
Provides direct nursing care including assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of patient care as well as coordinates the delivery of care provided by other care team members and disciplines. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Written and verbal communications, interpersonal skills. Basic organizational skills. Basic computer skills. Demonstrated leadership abilities. Patient assessment. Clinical education related to specialty. Principles of patient/family teaching. Required Experience : Current California RN license Current BLS and NRP certifications Two years NICU RN experience Address 12401 Washington Blvd. Salary 50.50-84.25 Shift Nights Shift Differential 7.00 Zip Code 90602
RN ICU Full-time
Prime Healthcare

Registered Nurse, RN - ICU

Prime Healthcare Lynwood, CA
$50.11 - $67.36 / hour
Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of diagnostic and treatment services in specialties including Cardiovascular, Surgical, Orthopedics, Obstetrics, Pediatrics, Behavioral Health, and Emergency and Trauma Care. In addition, the hospital offers a broad array of education and outreach programs that advance community health. St. Francis Medical Center is a Comprehensive Stroke Center, STEMI Receiving Center, ED Approved for Pediatrics, Geriatric ED, Level III Neonatal ICU, and Level II Trauma Center. Please visit www.stfrancismedicalcenter.com for more information. Join an award-winning team of dedicated professionals committed to compassion, quality, and service! Responsibilities The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. 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. They communicate with the physician about changes in the patient’s clinical condition including hemodynamic monitoring, results of diagnostic studies and abnormal results and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment. Maintains patient privacy and confidentiality. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Current and valid state RN License.2. Current BLS certificate upon hire and maintain current.3. Completion of Critical Care Course preferred. 4. Basic Arrythmia Interpretation within 30 days of hire.5. Current ACLS certificate 30 days upon hire and maintain current. 6. Minimum of one year as a staff RN in acute care hospital, critical care preferred.7. Critical Care RN (CCRN) Certification preferred. 8. Bachelor of Science in Nursing (BSN) preferred. Pay Transparency St. Francis Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. The current compensation range for this role is $50.11 to $67.36. 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. Employment Status Full Time Shift Nights Equal Employment Opportunity Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Privacy Notice Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf
RN Telemetry Full-time
PIH Health

Registered Nurse (RN), Cardiac Telemetry, Full time, 7pm-7:30am

PIH Health Whittier, CA
$50.50 - $84.25 / hour
Provides direct nursing care including assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of patient care as well as coordinates the delivery of care provided by other care team members and disciplines. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Written and verbal communications, interpersonal skills. Basic organizational skills. Basic computer skills. Demonstrated leadership abilities. Patient assessment. Clinical education related to specialty. Principles of patient/family teaching. Required Experience Current California RN license Evidence of continuing education Current experience in an acute care facility Current Basic Life Support Card Basic EKG interpretation required Current ACLS certification required NIHSS required Critical Care Course preferred Preferred ICU experience Address 12401 Washington Blvd. Salary 50.50-84.25 Shift Days Zip Code 90602
RN ICU Full-time
Emanate Health

R.N. II ICU - Full Time - Nights - 12hr QVH

Emanate Health Walnut Valley, CA
$48.97 - $74.88 / hour
Current Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals. 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. Job Summary The Staff RN is a professional caregiver who assumes responsibility and accountability for a group of patients for a designated time frame. He/she is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He/she ensures that quality care is provided in an efficient and safe manner consistent with the unit's standard of care. Utilizes nursing skills to determine the biophysical, psychosocial, environmental, self-care and educational needs of the patient/family/significant other to develop, implement and revise the plan of care. Job Requirements Minimum Experience Requirement: All (1) newly graduated nurses, (2) re-entry nurses, and (3) nurses new to the U.S. healthcare system must satisfactorily complete the Emanate Health R.N. New Grad Program. One year critical care experience is preferred. Excellent customer service skills required. Minimum License Requirement: Current RN license in the State of California. BLS certification required. ACLS required within three (3) months of hire/transfer. National Institutes of Health (NIH) Stroke Scale Certification "A" required within three (3) months of hire/transfer. Annual eight (8) hours of Stroke Education required for those working at QVH. Must be available to work every other weekend Delivering world-class health care one patient at a time. Pay Range: $48.97 - $74.88
RN NICU Full-time
PIH Health

Registered Nurse (RN), NICU, Full Time, Nights 12 Hours

PIH Health Los Angeles, CA
Responsible for independently utilizing the nursing process to safely, therapeutically and efficiently care for a group of patients based on policies and procedures. Delivers individualized quality patient care through a coordinated team approach with physicians, staff, other departments and the patient’s family. Complies with the California Nurse Practice Act, Article 2, Section 2725 of the Business and Professions Code. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Strong verbal & written communication skills Critical thinking skills Problem solving skills Computer skills Required Experience Current California RN License BLS from American Heart Association S.T.A.B.L.E. Certification preferred LA City Fire Card within 6 months of employment Neonatal Resuscitation from AAP & AHA (NRP) Vioence Intervention and Prevention (VIP) within three months of employment 1-Year recent experience or acceptance in /completion of a training program Address 1225 Wilshire Boulevard Shift Nights Zip Code 90017
RN ICU Full-time
PIH Health

Registered Nurse (RN), ICU, Full Time, Days

PIH Health Los Angeles, CA
$54.94 - $82.64 / hour
Responsible for independently utilizing the nursing process to safely, therapeutically and efficiently care for a group of patients based on policies and procedures. Delivers individualized quality patient care through a coordinated team approach with physicians, staff, other departments and the patient’s family. Complies with the California Nurse Practice Act, Article 2, Section 2725 of the Business and Professions Code. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Strong verbal & written communication skills Critical thinking skills Problem solving skills Computer skills Required Experience Current California RN License BLS from American Heart Association ACLS from American Heart Association NIH Stroke Scale (NIHSS) certification within 6 months of employment LA City Fire Card within 6 months of employment CPI/VIP within 3 months of employment (Emergency Room) 1-Year of experience Address 1225 Wilshire Boulevard Salary 54.94-82.64 Shift Days Zip Code 90017
RN ICU Full-time
PIH Health

Registered Nurse (RN), ICU, Full Time, NIghts

PIH Health Los Angeles, CA
$54.94 - $82.64 / hour
Responsible for independently utilizing the nursing process to safely, therapeutically and efficiently care for a group of patients based on policies and procedures. Delivers individualized quality patient care through a coordinated team approach with physicians, staff, other departments and the patient’s family. Complies with the California Nurse Practice Act, Article 2, Section 2725 of the Business and Professions Code. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Strong verbal & written communication skills Critical thinking skills Problem solving skills Computer skills Required Experience Current California RN License BLS from American Heart Association ACLS from American Heart Association (Telemetry, CVDOU, ICU, CICU, DOU, AMI, Emergency Room, Recovery Room, Radiology Invasive, Electrophysiology ) NIH Stroke Scale (NIHSS) certification within 6 months of employment (ICU, CICU Emergency Room, & DOU, Radiology Invasive only ) NIHSS preferred (Telemetry & CVDOU, Electrophysiology Emergency Room) PALS from AHA within 6 months of employment (Emergency Room only, Recovery Room only) LA City Fire Card within 6 months of employment (PHGSH only) CPI/VIP within 3 months of employment (Emergency Room) 1-Year Emergency Department experience (Emergency Room) Emergency Nursing Pediatric Course preferred (ENPC) (Emergency Room) Neonatal Resuscitation from AAP & AHA (NRP) (90 days within employment for New Grads) (NICU/Labor & Delivery) 1-Year recent experience or acceptance in /completion of a training program (NICU/Labor & Delivery) Chemo Certification within 1 year of employment (Respiratory) 6-month experience or acceptance in/completion of a New Grad/Internship program (Respiratory) Two (2) years’ experience in an acute care hospital (Radiology Invasive) One (1) year recent critical care experience or One (1) year Interventional Radiology or Cardiac Cath Lab experience (Radiology Invasive) 1-Year recent critical care experience or 1-Year Electrophysiology Lab experience ( Electrophysiology ) Address 1225 Wilshire Boulevard Salary 54.94-82.64 Shift Nights Zip Code 90017
RN Full-time
UCI Health

Clinical Nurse II-MST Float Pool Orange & Irvine- FT Night Shift

UCI Health Orange, CA
Who We Are UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. To learn more about UCI Health, visit www.ucihealth.org. Your Role on the Team Position Summary The clinical nurse collaborates with interdisciplinary teams to develop and implement a plan of care for a specific group of assigned patients, ensuring the coordination of care between other disciplines and support staff. Performs professional nursing duties that incorporate the psychomotor and age appropriate cognitive skills of the patient/family/significant other to assess, plan, intervene and advocate for the patient on an ongoing basis throughout the continuum of care. Will evaluate patient outcomes, effectiveness of plan of care, and readiness for discharge and revise plan or make referrals as necessary. Acts as a role model and mentor to a variety of students and nurses new to the unit. Functions as a (PCC) Patient Care Coordinator as requested by the supervisor/manager. Required Qualifications What It Takes to be Successful Must possess and maintain appropriate certifications, (NRP, PALS, etc.) per unit assignment, as required Minimum 2 years of recent experience in an acute care hospital setting Current California RN license All external candidates must have a Bachelor of Science in Nursing Ability to work variable shifts including evenings, nights, weekends, and holidays Ability to read, write and communicate effectively in English Ability to maintain flexibility and work well in a constantly changing environment Ability to float between Orange and Irvine campuses. Preferred Qualifications Understanding of applicable regulatory requirements Bilingual skills to communicate effectively with patients and families Bachelor of Science in Nursing Licenses And Certifications Registered Nurse Basic Life Support Advanced Cardiac Life Support Education Total Rewards We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits. Conditions Of Employment The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment: Background Check and Live Scan Employment Misconduct* Legal Right to Work in the United States Vaccination Policies Smoking and Tobacco Policy Drug Free Environment Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements. California Child Abuse and Neglect Reporting Act E-Verify Pre-Placement Health Evaluation Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php Closing Statement The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy. We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming. UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m. Consideration for Work Authorization Sponsorship Must be able to provide proof of work authorization
RN Director of Nursing Full-time
Skilled nursing facility

Director of Nursing

Skilled nursing facility Temple City, CA
What We’re Looking For: We’re looking for a dynamic Director of Nursing to lead our clinical team and provide our residents with an exceptional care experience. We need you to plan, organize, develop and direct the overall operation of your Nursing Service Department in accordance with current federal, state, and local standards, guidelines and regulations. Salary is based on experience. What You Will Do: Interview, hire, and train employees; plan, assign, and direct work; appraise performance; reward and discipline employees; address complaints and resolve problems Coordinate care and services to improve organization and implementation of plans of care, and quality of life and for all residents. Ensure proper assessment of all prospective residents prior to admission including visiting client at their home or in the hospital. Develop staffing plans that assure sufficient staffing to meet direct care needs, recommend numbers and types of nursing personnel necessary to provide care and maintain compliance Ensure 24hour availability as nursing administration resource by providing on-call and telephone access or designating an alternative, qualified nursing staff member to do so. Audit clinical records for accuracy and completeness of comprehensive resident assessments, effective documentation reflecting resident responses to interventions and consistent implementation of plans of care by all staff and professionals, on all shifts. Conduct quality assessment and assurance activities, including regulatory compliance rounds, in all departments to monitor performance and to continuously improve quality Lead and participate in interdisciplinary conferences as needed to develop adequate plans of care. Establish and maintain established policies, procedures, CQI programs and safety, environmental and infection control standards. Provide direct administrative and technical supervision of nursing, admissions and continuing care functions. Establish performance goals. Provide leadership in planning, organization, evaluation and fiscal management Collaborate with executive management team on Goals of our home Collaborate with interdisciplinary team members to develop and promote programs to enhance the resident’s quality of life and healthcare Ensure compliance with applicable local, state and federal regulations and the policies and procedures. Assist in the preparation of departmental budgets and allocation of funds based upon a review of department estimates and recommendations. What You’ll Bring: 2 years of DON experience in a California Skilled Nursing Facility preferred. Unrestricted RN license in the state of California Must be able to pass a background check