- Elevance Health (Costa Mesa, CA)
- ** Nurse Appeals ( RN )** **Location** : This role requires associates to be in-office **1-2** days per week, fostering collaboration and connectivity, while ... may be considered. **Shift: Monday to Friday from 8:00am-5:00pm PST** The ** Nurse Appeals ** is responsible for investigating and processing medical necessity… more
- Molina Healthcare (Long Beach, CA)
- …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in nursing. ... **JOB DESCRIPTION** **Job Summary** The **Delegation Oversight Nurse ** is responsible for ensuring that Molina Healthcare's UM delegates are compliant with all… more
- Prime Healthcare (Ontario, CA)
- …Utilization Review or Case Management with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA) certificate upon hire and maintain ... Service, to provide guidance on complex Authorizations, Referrals, Denials and Appeals . + Integrates and coordinates services using continuous quality improvement… more