RN Jobs in Seal Beach, CA

RN Full-time
Cedars-Sinai

Registered Nurse - Procedural - 12 Hour Days

Cedars-Sinai Los Angeles, CA
Job Description Cedars-Sinai is #1 in California and has been named to the Honor Roll for the tenth consecutive year in U.S. News & World Report's 'Best Hospitals 2025-26' rankings. Cedars-Sinai was awarded the Advisory Board Company’s Workplace of the Year which is an award that recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We also have a great benefits package and competitive compensation which explains why U.S. News & World Report has named us one of America’s Best Hospitals! Why work here? Beyond outstanding benefits, competitive salaries and health and dental insurance we take pride in hiring the best, most passionate employees. Our talented staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for. Qualifications Qualifications: Education: Graduate of an accredited nursing program required BSN preferred License/Certifcation: Current, unrestricted California RN license required ACLS and PALS from the American Heart Association or American Red Cross required CGRN, CCRN or CPAN certification preferred Experience: A minimum of 3 year of acute care nursing experience in GI Lab Procedures or Critical Care preferred Moderate Sedation administration experience preferred Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address. Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring. At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through March each year) as a condition of employment, and annually thereafter as a condition of continued employment.
RN Full-time
Adventist Health

RN, Risk Management Specialist (White Memorial)

Adventist Health Los Angeles, CA
Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary Performs key responsibilities that support the department in achieving risk management program goals for the organization. Key duties include initiation and review of new claims in the Event Reporting System; grievances, complaints and concerns triage, review, and resolution, and general administrative support to the Risk Management Director. Works collaboratively with stakeholders including but not limited to: Risk Management, Claims, Legal, Patient Safety, Quality, Accreditation, Regulatory, and Licensing teams. Serves as a risk management generalist to facilitate and perform the duties of the risk management department on a variety of hospital and clinic related topics including collaboration and communication with various stakeholders, patients, and medical staff. Job Requirements Education and Work Experience: Bachelor's Degree in Nursing (BSN): Preferred Three years' nursing experience or general risk management: Required One year leadership experience: Preferred Familiarity with professional liability insurance/claims handling: Preferred Licenses/Certifications Registered Nurse (RN) licensure in the state of practice: Required Essential Functions Assists with identifying and managing actual and potential risks to the organization. Reviews and manages event reporting system related to grievances, complaints, workplace violence, security, property, facilities, and claims, and other events as assigned Participates in patient safety event review meetings and completes necessary follow up. Initiates review of events with high harm and potentially compensable events (PCEs). Acts as a liaison and resource to assess risk exposures in specific clinical and other situations (e.g. Facilities, Safety, Nursing, Pharmacy, Security, and Patient Relations). Works with Safety, Procurement, and Clinical Engineering and Clinical Operations to identify medical device and equipment failures for purposes of improving organizational risk, patient safety and for reporting to the Food and Drug Administration (FDA). Participates as member of varous organizational councils/committees to provide risk management perspective and input for purposes of managing organizational risk and promoting safety activities. Ensures timely and accurate response to inquiries for claims history and coverage information. Monitors evidence preservation (e.g. surveillance video, equipment, etc, and/or litigation holds). Collaborates with Risk Management Director or Manager, Claims team, or internal or external legal counsels to coordinate reviews processes and procedures. Obtains, maintains records and documents and provides them to internal or external legal counsels for preparation of testimony in pending litigation Safeguards documents obtained or developed for cause analysis to ensure documents/proceedings are protected from discovery. Participates in claims process which includes but is not limited to: coordination of depositions; response to interrogratories; requests for production of evidence; ensuring documentation and data management. Ensures timely and accurate response to inquiries for claims history and coverage information. Monitors evidence preservation (e.g. surveillance video, equipment, etc, and/or litigation holds) Attends trial as site representative as directed by internal and external legal counsels. Safeguards documents obtained or developed for cause analysis to ensure documents/proceedings are protected from discovery. Supports Risk Management Director and various department leaders in analyzing data (e.g. complaints, grievances, claims, lawsuits) to identify priority topics and audiences for targeted training and education. Assists department staff to coordinate inservices and education related to risk prevention, reduction, and mitigation strategies 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 Manager/Supervisor NICU Full-time
Providence

Assistant Nurse Manager - NICU

Providence Torrance, CA
$68.94 - $108.84 / hour
Description Assistant Nurse Manager at Providence Little Company of Mary Medical Center in Torrance, CA. This position is Full-Time and will work 8-hour evening shifts. Providence Little Company of Mary in Torrance has been recognized as a Magnet® hospital—a prestigious designation from the American Nurses Credentialing Center (ANCC), which recognizes organizations that provide the highest-quality care. Only 9.96% of U.S. hospitals earn Magnet® recognition, which fitals are four times designated. We have also been celebrated in 2025 as one of America’s Best-In-State Hospitals by Newsweek and recognized by U.S. News & World Report for excellence in 11 types of care. We are also proud to be included in the Maternity Care Honor Roll by the California Surgeon General for 2024. The Assistant Nurse Manager (ANM) is a professional Registered Nurse reporting to the unit director/manager who utilizes the nursing process to manage clinical and operational activities within assigned shift. The ANM is responsible for supporting the director/manager in planning, organizing, directing, and evaluating services of the unit and providing managerial presence for all shifts. The ANM is responsible for managing clinical and non-clinical caregivers and providing input to the director/manager for evaluation purposes related to performance. Duties include but not limited to compliance to professional nursing standards and regulatory requirements, implementing and monitoring compliance to policies, processes and clinical priorities, coaching, mentoring and collaborating to deliver quality health care to patients. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Little Company Of Mary Torrance Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Bachelor's Degree: Graduate from School of nursing (BS, or BSN). Registered Nurses employed in this role prior to November 1, 2024 are encouraged to pursue the BSN degree but obtaining the degree will not be a condition of employment. California Registered Nurse License upon hire National Provider BLS - American Heart Association upon hire Preferred Qualifications: Recent clinical experience in an acute care hospital. Charge Nurse/Relief Charge Nurse experience. Leadership experience. Shared Governance experience. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. About Providence At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits . Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act . About the Team The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond. Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School. Providence is proud to be an Equal Opportunity Employer . We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 429684 Company: Providence Jobs Job Category: Nursing-Patient Facing Job Function: Nursing Job Schedule: Full time Job Shift: Evening Career Track: Leadership Department: 7014 LCMT NICU Address: CA Torrance 4101 Torrance Blvd Work Location: Providence Little Co of Mary Medical Ctr-Torrance Workplace Type: On-site Pay Range: $68.94 - $108.84 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
RN Full-time
MemorialCare

Registered Nurse (RN) - Special Procedures

MemorialCare Long Beach, CA
$50 - $74.98 / hour
Title: Registered Nurse (RN) Location: Long Beach Department: Special Procedures Status: Full Time Shift: Days (10hr Shift) Pay Range* : $50.00 - $74.98 At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary The RN, Registered Nurse 10-Hr provides safe, cost-effective patient care through the health experience, according to established standards utilizing the nursing process, within the scope of practice of Registered Nursing, for Special Procedures at MemorialCare Long Beach Medical Center. To provide safe, cost-effective patient care through the health experience, according to established standards utilizing the nursing process, within the scope of practice of Registered Nursing. Essential Functions and Responsibilities of the Job Safety and risk management Assess patients Develops a written plan of care using assessment database Implements patient care Evaluates and revises patient care Staff development Collaboration and working with others Interpersonal relationships and communication Unit, department, and hospital contributions Performance appraisal Working responsibilities Customer services Skills Roster *Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more... Check out our MemorialCare Benefits for more information about our Benefits and Rewards.
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 Educator ER Full-time
PIH Health

Registered Nurse (RN) Clinical Educator, Emergency Department, Full-Time, 7:30 AM - 4:30 PM

PIH Health Downey, CA
$53.70 - $88.50 / hour
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 Evidence of self-development Minimum three years clinical experience in acute care setting Preferred: MSN preferred. Specialty experience preferred (such as Critical Care) Address 11500 Brookshire Ave. Salary 53.70-88.50 Shift Days Zip Code 90241
RN Labor and Delivery Per Diem
CareRev

Labor and Delivery Nurse in Torrance, CA (Per Diem Shifts)

CareRev Torrance, CA
$78 - $79 / hour
CareRev is looking for experienced Labor and Delivery Registered Nurses in Torrance, CA to find and claim per diem shifts at local hospitals. As an L&D Nurse, you will support patients throughout the birthing process, monitor maternal and fetal health, assist with deliveries, and provide compassionate postpartum care. With CareRev, you choose your own schedule and claim shifts that align with your life, giving you professional flexibility without sacrificing meaningful clinical work. The CareRev app empowers healthcare professionals to find and claim local per diem shifts on demand. Choose the days you work and pick shifts that fit your schedule, whether that's days, evenings, or nights. Work where you want, when you want, with the freedom to build a schedule that works for your life. No burnout. No hassle. Torrance offers a warm, community-oriented lifestyle in the heart of the South Bay, with access to beaches, parks, and an excellent local dining scene. Wilson Park is a favorite gathering spot for families, with a farmers market running on weekends that draws residents from across the community. The Torrance Cultural Arts Center hosts concerts, theater productions, and community events throughout the year, and the Pacific Coast Highway corridor connects Torrance to the broader coastline, making it easy to spend your days off exploring some of California's most beautiful shoreline. Ready to take control of your schedule? Download the CareRev app today and start finding and claiming per diem shifts that fit your life. Current RN license and good standing with the State Board of Nursing. Current AHA ACLS, BLS, NRP, AWHONN Advanced, and FHM certifications. Minimum of 3-years experience as an L&D RN. EPIC experience required. Experience circulating C-sections is a plus! Strong assessment skills surrounding pregnancy and labor including high risk cases. Must show competency with infant stabilization and electronic fetal heart monitoring and interpretation. Comfortable floating to Postpartum/MBU. References that cover 1 year of employment in their specialty within the last 3 years. 1 reference must be a supervisor, charge RNs accepted. Must live within 55 miles of facility.
RN Telehealth Full-time
UnitedHealthcare

Clinical Appeals RN - Remote in EST or CST Time Zone

UnitedHealthcare Cypress, CA
$29 - $52 / hour
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. If you are located within Eastern Standard time zone, you will have the flexibility to work remotely* as you take on some tough challenges. The work schedule is generally Monday-Friday, 8-5 EST or 8-5 CST- you will work within the time zone hours you reside in. Primary Responsibilities Perform initial assessment review of appeals, medical records, and CMS/State Policies to determine if care/services provided meets coverage and billable criteria to be paid Identify if additional information is required to process an appeal Ability to adapt to changes that require cross training on appeal types as they are identified Ability to work independently Utilize Clinical nursing judgment assessment and critical thinking skills, guided by regulatory policy, to make decision on administrative nurse level cases Ability to navigate multiple computer programs, moving from one system to another, while managing multiple tasks and priorities You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Current, valid, and unrestricted RN licensure in your state of residence 2+ years of clinical experience in an acute care or an outpatient setting 1+ years of direct experience within one (or more) of the following areas: Utilization Review Medicaid and/or Medicare appeals experience LOC assessment planning and Discharge SNF Planning including understanding of Denial Notice and NOMNC Proven experience/understanding of billable services and claims in a managed care environment Solid Microsoft Office (Word, Excel & Outlook) Basic computer skills Access to high-speed internet Ability to work 8-5 within EST or CST (Eastern standard time zone/ Central Standard time zone) Preferred Qualifications 5+ years of Medical Appeal experience working with Medicare and Medicaid Solid coding experience or Certified Coder (CPC) All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Med-Surg Contract
Prime Healthcare

Registered Nurse, RN - Med/Surg

Prime Healthcare Lynwood, CA
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 within the Medical/Surgical Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient’s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Current and valid state RN License.2. Current BLS certificate upon hire and maintain current.3. Current ACLS certificate 30 days upon hire and maintain current preferred.4. Previous Acute Care hospital experience preferred.5. Ventilator Management experience preferred.6. Bachelor of Science in Nursing (BSN) preferred. Pay Transparency St. Francis Medical Center offers competitive compensation and the current compensation range for this role is $58.05. Benefits may vary based on collective bargaining agreement requirements and/or the employment status. 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 Per Diem Shift Days 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 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 ER Full-time
Adventist Health

RN, Care Manager (Emergency Dept) - Per Diem, Day Shift

Adventist Health Montebello, 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 Establishes, coordinates, and maintains the process to increase patient through-put to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the Emergency Department (ED). Collaborates with the patient/family, multidisciplinary team, physicians, community resources and payers to ensure the patient’s progress and level of care is appropriately determined for the emergency episode of care and for the inpatient encounter to ensure that care is performed and facilitated in an efficient and cost-effective manner. Uses well developed knowledge and skills in patient status determination (InterQual Criteria), in the assessment and care management of patients and families within the ED, inpatient and outpatient settings. Practices patient/family assessment and management, resource management, identifying patients appropriate for inpatient admission, observation, or outpatient status, care facilitation, discharge planning with referral to all levels of care, and other related duties specific to the defined patient population. Collaborates with other case managers, social work staff, the access center, admissions, and other physician and administrative leadership staff within the ED, the care management department and both the inpatient and outpatient settings. Uses knowledge of pathophysiology, pharmacology, and clinical care processes to participate with other clinical staff and physicians in the development of clinical practice guidelines and physician order sets for the purpose of improving quality of care, changing practice, and reducing costs. Job Requirements Education and Work Experience: Bachelor's Degree in Nursing (BSN): Preferred Master's Degree in nursing or health care related field: Preferred Experience in case management, utilization management, and/or transitional care: Preferred Licenses/Certifications Registered Nurse (RN) licensure in the state of practice: Required Accredited Case Manager, Certified Case Manager, or Board Certification in Case Management: Preferred Facility Specific License/Certifications Hospital Fire and Life Safety (HLFS): Required Essential Functions Acts as a resource to ED staff and physicians regarding appropriateness of admission, levels of care (including related documentation requirements and observation vs. inpatient requirements), quality of care concerns and criteria/guidelines/protocols utilized in care planning and resource utilization. Gathers sufficient information from and communicates with all relevant sources to facilitate appropriate discharge from ED to appropriate level of care to assure it is done in an accurate, safe, timely and cost-effective manner to prevent readmission and/or frequent visits to ED. Assists in triaging calls from other acute care facilities requesting patient transfers to EMC; determines transfer appropriateness by reviewing requested documentation and InterQual level of care criteria and discussions as necessary with admitting physician, supervisors and/or EMC administrators and/or other EMC personnel. Assesses ED patients and identifies options other than acute hospital admission when appropriate. Screens and refers to acute rehabilitation, long-term acute care hospitals, and nursing homes for admission directly from the ED; screens and refers patients to clinics after initial exam; and screens and refers patients for whom treatments could be safely rendered at home with services (e.g., IV antibiotics, low molecular weight heparin injections, wound care, etc.). Organizes, integrates, and evaluates the effectiveness of the plan of care and progress toward achievement of desired outcomes. Modifies plan of care as patient/family needs change to accomplish goals established in the plan of care. Communicates plan of care, including changes and issues related to plan of care to patient/family, physicians, and other members of the healthcare team. 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 CVICU Full-time
Prime Healthcare

*Registered Nurse, RN - CCU (CVICU)

Prime Healthcare Inglewood, CA
$43.68 - $62.41 / hour
Overview At Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in the United States, Centinela Hospital Medical Center is actively seeking new members to join its award-winning team! Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for 100 years. An award-winning facility, ranking in the top 5% nationally for quality and patient safety, Centinela Hospital is a 362-bed acute-care hospital with a 24-hour STEMI certified emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, inpatient and outpatient rehab programs, and more. Centinela has earned hundreds of national awards and recognitions, including "100 Top Hospital" recognition from Fortune/Merative and straight 'A's (2018-2024) for hospital safety from The Leapfrog Group. For more information, visit www.centinelamed.com. Responsibilities The Registered Nurse is directly responsible for the care given to his/her assigned patients. He/She communicates 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 and Work Experience Current valid CA Registered Nurse license. Completion of Critical Care Course preferred. Current BCLS certificate upon hire and maintain current. Current ACLS certificate upon hire and maintain current. Previous Critical Care experience preferred. Pay Transparency Centinela Hospital 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 $43.68 to $62.41. 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 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 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 Full-time
Cedars-Sinai

Registered Nurse II – Float Pool, Full-time, 7AM Day Shift

Cedars-Sinai Marina del Rey, CA
Job Description Make a difference every single day! Are you ready to bring your strong clinical competencies and make a crucial impact on the lives of others? Do you have a passion for the highest quality and patient satisfaction? Then please respond to this dynamic opportunity available with one of the best places to work in Southern California! We would be happy to hear from you at Cedars-Sinai Marina Del Rey Hospital , where we are now a Primary Stroke Center and building a brand new 9 story hospital. Join us and support our community with the highest quality healthcare! $10,000 Employee Referral Program bonus eligible Join our Float Pool: We are seeking a compassionate, dedicated RN who enjoys variety to support multiple hospital units on a rotating basis. You will play a critical role in patients' lives every day. As a Registered Nurse II (RN II) in the Float Pool, you will be oriented to multiple inpatient departments. Our nursing Float Pool supplements staffing throughout the hospital based on need. Nurses who work in the Cedars-Sinai Float Pool can float between multiple areas. This position will focus primarily on our Medical Surgical, Telemetry, MSSU and Ortho Units PCU and Critical Care (ICU, PCU & ED as needed) Enjoy the flexibility of being a float-pool nurse while building your career at Cedars-Sinai: You'll get exposure to several different disciplines while making a positive impact on the lives of a diverse patient population. At Cedars-Sinai Marina Del Rey Hospital, you'll learn from dedicated healthcare professionals every single day and do something incredible – for yourself and for others. Our Units: The Float Pool is a high level performing department staffed with healthcare professionals who are equipped to work in various areas of the hospital. These highly trained professionals working in the Float Pool support the organization by having the ability to care for some or all of the specialty patient populations. The organization has several specialty units that the float pool supports which include: Medical-Surgical/Telemetry units (MS/TELE), Short Stay, Ortho, and possibly our Intensive Care Unit (ICU), Emergency Department (ED), Progressive Care Unit (PCU). Position Summary: The Registered Nurse assumes accountability and responsibility for the delivery of patient care in the hospital setting and for the respective patient population. Provides direct and indirect patient care services, including the administration of medications and therapeutic agents necessary to implement treatment, disease prevention, or rehabilitative plan of care. Demonstrates advanced assessment skills to evaluate the signs, symptoms, reactions, behaviors, or general appearance to determine normal versus abnormal characteristics. Displays knowledge and is able to identify and make special adjustments to the specific populations needs, including cultural, spiritual, age, psychosocial, communication, gender, sexual orientation, economic, education, family and condition needs. Provides assistance to co-workers, new staff, temporary staff and students Functions as a change champion and agent and participates in departmental quality improvement activities Benefits: NEW 9 story Hospital scheduled for May 2027 – state of the art and double the size! Advancement and leadership opportunities, including Clinical Ladder Program! Amazing benefits! Magnet journey started! Tuition Assistance Plans: We offer the following on the first day of employment! Tuition Reimbursement: Repays up to $600 per calendar year for fees expended to attend a job-related seminar, licensure renewal, workshop, conference, individual course, or other training programs. Tuition Loan: Provides up to $2,000 per calendar year for approved formal certificate or degree programs including prerequisites for approved degree programs. A tuition loan and reimbursement may, with appropriate approvals, be combined for a maximum of $2,600. Critical Pipeline Loan: Tuition loans up to $5,250 for specific degree programs at approved, accredited schools identified by the organization, including BSN and MSN. Employees may have their loans Forgiven if they continue eligible employment for 12 months after completion of the term for which the loan was given Hours: 7:00 a.m. – 7:30 p.m. Days Qualifications Educational Requirements: Graduate of an accredited nursing program. BSN is preferred Associate's Degree in Nursing required License/Certifications: Valid California RN license BLS through the American Heart Association or American Red Cross ACLS certification through the American Heart Association or American Red Cross PALS if floating to the Emergency Department Experience: A minimum of 2 years of acute care nursing experience required Demonstrated dedication to customer service and ability to meet the needs and expectations of patients and health care colleagues
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 Manager/Supervisor NICU Full-time
Providence

Assistant Nurse Manager - NICU Full-time Evening

Providence Torrance, CA
$68.94 - $108.84 / hour
Description Assistant Nurse Manager at Providence Little Company of Mary Medical Center in Torrance, CA. This position is Full-Time and will work 8-hour evening shifts. Providence Little Company of Mary in Torrance has been recognized as a Magnet® hospital—a prestigious designation from the American Nurses Credentialing Center (ANCC), which recognizes organizations that provide the highest-quality care. Only 9.96% of U.S. hospitals earn Magnet® recognition, which fitals are four times designated. We have also been celebrated in 2025 as one of America’s Best-In-State Hospitals by Newsweek and recognized by U.S. News & World Report for excellence in 11 types of care. We are also proud to be included in the Maternity Care Honor Roll by the California Surgeon General for 2024. The Assistant Nurse Manager (ANM) is a professional Registered Nurse reporting to the unit director/manager who utilizes the nursing process to manage clinical and operational activities within assigned shift. The ANM is responsible for supporting the director/manager in planning, organizing, directing, and evaluating services of the unit and providing managerial presence for all shifts. The ANM is responsible for managing clinical and non-clinical caregivers and providing input to the director/manager for evaluation purposes related to performance. Duties include but not limited to compliance to professional nursing standards and regulatory requirements, implementing and monitoring compliance to policies, processes and clinical priorities, coaching, mentoring and collaborating to deliver quality health care to patients. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Little Company Of Mary Torrance Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Bachelor's Degree: Graduate from School of nursing (BS, or BSN). Registered Nurses employed in this role prior to November 1, 2024 are encouraged to pursue the BSN degree but obtaining the degree will not be a condition of employment. California Registered Nurse License upon hire National Provider BLS - American Heart Association upon hire Preferred Qualifications: Recent clinical experience in an acute care hospital. Charge Nurse/Relief Charge Nurse experience. Leadership experience. Shared Governance experience. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. About Providence At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits . Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act . About the Team The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond. Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School. Providence is proud to be an Equal Opportunity Employer . We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 429684 Company: Providence Jobs Job Category: Nursing-Patient Facing Job Function: Nursing Job Schedule: Full time Job Shift: Evening Career Track: Leadership Department: 7014 LCMT NICU Address: CA Torrance 4101 Torrance Blvd Work Location: Providence Little Co of Mary Medical Ctr-Torrance Workplace Type: On-site Pay Range: $68.94 - $108.84 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
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
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 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 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 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 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 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 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