RN Full-time

At Reliant Management, we are committed to providing high-quality, compassionate care in long-term care and rehabilitation settings. We're seeking a detail-oriented Administrative Nurse to join our Anaheim-based team. This role plays a critical part in ensuring accurate, timely, and compliant chart documentation across our facilities.

 

Job Description:

  • Conduct regular audits of nursing documentation and medical charts for accuracy and regulatory compliance

  • Review resident care records to ensure completeness and consistency with policies and procedures

  • Collaborate with facility staff and leadership to address documentation issues or discrepancies

  • Provide feedback, training, and support to improve charting practices and adherence to standards

  • Stay current on regulatory updates (CDPH, CMS) to inform audit processes and documentation expectations

  • Assist with preparing facilities for surveys and inspections

  • Maintain confidentiality and HIPAA compliance at all times

 

Qualifications:

  • Current California RN or LVN license in good standing

  • Minimum of 2 years of clinical nursing experience, preferably in long-term care or skilled nursing

  • Prior experience in chart auditing, MDS review, or nursing administration strongly preferred

  • Strong knowledge of nursing documentation standards, Title 22, and CMS regulations

  • Excellent attention to detail and organizational skills

  • Effective communication skills and ability to work independently and with remote teams

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

RN ICU Full-time
PIH Health

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

Responsible for independently utilizing the nursing process to safely, therapeutically and efficiently care for a group of patients based on policies and procedures. Delivers individualized quality patient care through a coordinated team approach with physicians, staff, other departments and the patient’s family. Complies with the California Nurse Practice Act, Article 2, Section 2725 of the Business and Professions Code. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Strong verbal & written communication skills Critical thinking skills Problem solving skills Computer skills Required Experience Current California RN License BLS from American Heart Association ACLS from American Heart Association (Telemetry, CVDOU, ICU, CICU, DOU, AMI, Emergency Room, Recovery Room, Radiology Invasive, Electrophysiology ) NIH Stroke Scale (NIHSS) certification within 6 months of employment (ICU, CICU Emergency Room, & DOU, Radiology Invasive only ) NIHSS preferred (Telemetry & CVDOU, Electrophysiology Emergency Room) PALS from AHA within 6 months of employment (Emergency Room only, Recovery Room only) LA City Fire Card within 6 months of employment (PHGSH only) CPI/VIP within 3 months of employment (Emergency Room) 1-Year Emergency Department experience (Emergency Room) Emergency Nursing Pediatric Course preferred (ENPC) (Emergency Room) Neonatal Resuscitation from AAP & AHA (NRP) (90 days within employment for New Grads) (NICU/Labor & Delivery) 1-Year recent experience or acceptance in /completion of a training program (NICU/Labor & Delivery) Chemo Certification within 1 year of employment (Respiratory) 6-month experience or acceptance in/completion of a New Grad/Internship program (Respiratory) Two (2) years’ experience in an acute care hospital (Radiology Invasive) One (1) year recent critical care experience or One (1) year Interventional Radiology or Cardiac Cath Lab experience (Radiology Invasive) 1-Year recent critical care experience or 1-Year Electrophysiology Lab experience ( Electrophysiology ) Address 1225 Wilshire Boulevard Salary 53.08-79.95 Shift Days Zip Code 90017
L.A. Care Health Plan

Utilization Management Nurse Specialist RN II

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 Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures timely and accurate determination and notification of referrals and reconsiderations based on the referral determination status. Generates approval, modification and denial communications, to include member and provider notification of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review. Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers. Acts as a department resource for medical service requests /referral management and processes. Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps. Follows up with caller to provide response or resolution steps. Answers all inquiries in a professional and courteous manner. Duties Promote and support team engagements, programs and activities to create and ensure a positive and productive workplace environment. Perform telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, the member and significant others to develop and implement a successful discharge plan. Process, finalize and facilitate inbound requests that are received from providers. Generate appropriate member and provider communication for all determinations within the required timelines as defined by the most current department policy. Facilitate/review requests for Higher level of care or skilled nursing/discharge planning needs. Research for appropriate facilities, specialty providers and ancillary providers to utilize for all lines of business. Identification of potential areas of improvement within the provider network. Identify and initiate referrals for appropriate members to the various L.A. Care programs/processes and external community based programs or Linked and Carve Out Services (e.g. DDS/CCS/MH). Potential quality of care/potential fraud issues are identified and documented per L.A. Care policy. High risk/high cost cases and reports are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize designated software system to document reviews and/or notes. Receive incoming calls from providers, professionally handle complex calls, research to identify timely and accurate resolution steps. Follow up with caller to provide response or resolution steps. Answer all inquiries in a professional and courteous manner. 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 varied RN clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group or management services organization. Experience with Managed Medi-Cal, Medicare, and commercial lines of business. Skills Required: Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint. Effectively utilizes computer and appropriate software and interacts as needed with L.A. Care Information System. Knowledge of personal computer, keyboarding, and appropriate software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Prepare clear, comprehensive written and oral reports and materials. Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team Excellent time management and priority-setting skills. Maintains strict member confidentiality and complies with all HIPAA requirements. Strong verbal and written communication skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge of Department of Health Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light Additional Information May work on occasional weekends and some holidays depending on business needs. 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 PACU Full-time
PIH Health

Registered Nurse (RN), ASC PREOP/PACU , Full Time, Days 10HR

Responsible for independently utilizing the nursing process to safely, therapeutically and efficiently care for a group of patients based on policies and procedures. Delivers individualized quality patient care through a coordinated team approach with physicians, staff, other departments and the patient’s family. Complies with the California Nurse Practice Act, Article 2, Section 2725 of the Business and Professions Code. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Strong verbal & written communication skills Critical thinking skills Problem solving skills Computer skills Required Experience Current California RN License BLS from American Heart Association ACLS from American Heart Association PALS from AHA within 6 months of employment LA City Fire Card within 6 months of employment 2 year acute care or ambulatory surgery experience Address 1225 Wilshire Boulevard Salary 53.08-79.95 Shift Days Zip Code 90017
RN ICU Full-time
PIH Health

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

Responsible for independently utilizing the nursing process to safely, therapeutically and efficiently care for a group of patients based on policies and procedures. Delivers individualized quality patient care through a coordinated team approach with physicians, staff, other departments and the patient’s family. Complies with the California Nurse Practice Act, Article 2, Section 2725 of the Business and Professions Code. PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook , Twitter , or Instagram . Required Skills Strong verbal & written communication skills Critical thinking skills Problem solving skills Computer skills Required Experience Current California RN License BLS from American Heart Association ACLS from American Heart Association NIH Stroke Scale (NIHSS) certification within 6 months of employment LA City Fire Card within 6 months of employment 1-Year of experience Address 1225 Wilshire Boulevard Salary 53.08-79.95 Shift Nights Zip Code 90017
RN Full-time
L.A. Care Health Plan

Quality Management Nurse Specialist RN II

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 Quality Management Nurse Specialist RN II is responsible for overseeing the clinical aspects for quality improvement projects/activities, which may include but are not limited to the clinical review process for potential quality of care and service issues, regulatory compliance with CMS, DMHC, DHCS, and NCQA. This position is responsible for ensuring program activities are completed in a high quality and timely manner and ensuring compliance with all regulatory guidelines such as Medicaid (Medi-Cal), Medicare, and the Health Exchange, as well as National Committee for Quality Assurance (NCQA) Accreditation. Duties Leads and/or participates in multi-department/cross-functional committees and work groups which support key initiatives, prepares reports, data, agendas/minutes or other materials for committee presentation and management. Develops and implements project-related communication including, but not limited to, member/physician mailings, IVR scripts, emails, business plans, graphics, and maintains minutes and agendas. Develops and/or maintains relationships with other external organizations to expand key partnerships. Creates, maintains and implements training/education and supporting documentation for internal and external clients/customers/members. Develops and submits regulatory reports at the time and in the manner required by state or federal agencies such as Centers for Medicare and Medicaid Services(CMS). Conducts/ performs clinical review of assigned potential quality issue cases (PQI), and close cases within regulatory timeframe, and presents appropriate cases to the peer review committee for action and resolution 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 clinical experience as an RN in an acute hospital setting. Preferred: Experience with regulatory compliance such as CMS, DMHC, DHCS, and NCQA. At least 5 years of managed care and/or quality improvement experience as an RN in a managed care/ healthcare setting preferably with Medicare ,Medi-Cal, or other government programs. Experience in the review of quality of care and service concerns, preferably complaints from member grievance. Experience in compliance, accreditation, service or quality improvement. Experience in facilitating workgroups and project management. Skills Required: Must have excellent written and verbal communication and presentation skills. Ability to manage projects independently and assume responsibility for successful completion. Ability to develop and maintain strong working relationships with internal and external clients/ customers /members. Must have excellent analytical skills, working knowledge of statistics and reporting. Must be detail-oriented and effective critical thinking skills. Proficient in Microsoft Office (Word, Excel). Strong interpersonal skills and high level of professionalism. Ability to work independently and within a team environment. Preferred: Knowledge in the community standards of practice, including clinical guidelines. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Professional in Healthcare Quality (CPHQ) Required Training Physical Requirements Light Additional Information Preferred: CPHQ or familiarity with quality improvement methodology such as Lean Six Sigma or Plan-Do-Study-Act. 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)