RN Full-time

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Job Overview

The Registered Nurse (RN) assumes the responsibility for the application of nursing and clinical processes and delivery of quality patient care at AltaMed clinics under the supervision of the Nursing Supervisor, Nursing Director, or CNE and has accountability for the nursing process and the delivery of efficient patient care. RN supports patient evaluation, and carries out related nursing interventions, supports nursing patient evaluation, efficient system applications, and recording of patient care/behavior. Works collaboratively with the clinic interdisciplinary team members, medical staff, clinical operations, and the Administrative/Operational Leadership teams to ensure the achievement of patient, clinical, or program goals as appropriate. Provides clinical care and demonstrates clinical competency in the area of specialty for patient populations. Application of and knowledge of regulatory requirements in the delegation of tasks and in documentation. Assist in the development and implementation of quality, cost-effective, efficient systems and protocols for standardizing processes of patient care at clinics. Within Health Services, may work as the Triage Nurse in Urgent Care, Primary Care Nurse in the Nurse Clinic, or the Charge Nurse on the floor at each clinic. Nursing job duties are to comply with the Nurse Practice Act, Title 22, Joint Commission (JC), CMS 42 CFR Part 460 regulatory requirements as appropriate. The plan for the provision of nursing care to patients aligns with the AltaMed Code of Conduct, professional and educational standards, and requirements as needed.

Minimum Requirements

  • Accredited school of nursing graduate with a current California State Board of Nursing Registered Nurse License required.    

  • Minimum of 1 year of experience as a Registered Nurse preferred

  • Experience in an ambulatory care environment, i.e., clinic or Urgent Care setting, preferred.

  • Bilingual English/Spanish, preferred. Bilingual in other languages or experience in American Sign Language is highly desirable.

  • A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines.

Compensation

Pay for this job starts at $50.00 hourly

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

  • Medical, Dental and Vision insurance
  • 403(b) Retirement savings plans with employer matching contributions
  • Flexible Spending Accounts
  • Commuter Flexible Spending
  • Career Advancement & Development opportunities
  • Paid Time Off & Holidays
  • Paid CME Days 
  • Malpractice insurance and tail coverage
  • Tuition Reimbursement Program
  • Corporate Employee Discounts
  • Employee Referral Bonus Program
  • Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

RN Home Health Full-time
AccentCare, Inc.

RN Case Manager, Home Health

Overview RN / Registered Nurse, Home Health Location: West Hills Position: RN Case Manager, Home Health Position Type: Full-Time Remote/Virtual Position: No Coverage Area: Santa Clarita & San Fernando Valley Find Your Passion and Purpose as an Registered Nurse, Home Health Case Manager Salary: Depending on Experience Schedule: Mon-Fri & on-call rotation one weekend a month //player.vimeo.com/video/1036777653?title=0&byline=0 Offer Based on Years of Experience What You Need to Know Reimagining Your Career in Home Health Caring for others is more than what you do — it’s who you are. At AccentCare, you’ll join a purpose-driven, collaborative culture that sets the standard for excellence and gives you the trust and tools to do your best work. You’ll belong to a team that cares deeply for patients and each other; a team committed to consistently providing exceptional care. We’re proud to be named one of America’s Greatest Workplaces 2025 by Newsweek — a reflection of our shared commitment to excellence, integrity and compassion as we shape the future of aging in place. When you thrive, so does the community of care we’re building together. Be the Best RN Case Manager You Can Be If you meet these qualifications, we want to meet you! Graduate from an approved school of professional nursing and currently licensed to practice as a registered nurse in the state of agency operation. One (1) year experience as a RN. Required Certifications and Licensures: Licensed to practice as a registered nurse in the state of agency operation. Must possess and maintain valid CPR certification while employed in a clinical role. Must be a licensed driver with an automobile that is insured in accordance with state and/or organization requirements and is in good working order. Ability to travel to all business locations. Our Investment in You Caring for others starts with caring for you. We’re committed to fostering a purpose-driven workplace where you feel supported, and that means prioritizing your physical, financial and mental well-being. Our benefits include: Medical, dental, and vision coverage Paid time off and paid holidays Professional development opportunities Company-matching 401(k) Flexible spending and health savings accounts Wellness offerings such as an employee assistance program, pet insurance, and access to Calm, a meditation, sleep, and relaxation app Programs to celebrate achievements, milestones, and fellow employees Company store credit for your first AccentCare-branded scrubs for patient-facing employees And more! Why AccentCare? Come As You Are At AccentCare, you’re part of a community that cares — for patients and each other. You can rest assured we offer equal employment opportunities regardless of race, ethnicity, sex, sexual orientation, gender identity, religion, national origin, age or disability.
RN Full-time
Molina Healthcare

Lead, DRG Coding/Validation (RN)

$76,425 - $149,028 / year
JOB DESCRIPTION Job Summary Provides lead level support developing diagnosis-related group (DRG) validation tools and process improvements - ensuring that member medical claims are settled in a timely fashion and in accordance with quality reviews of appropriate ICD-10 and/or CPT codes, and accuracy of DRG or ambulatory payment classification (APC) assignments. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Develops diagnosis-related group (DRG) validation tools to build workflow processes and training, auditing and production management resources. • Identifies potential claims outside of current concepts where additional opportunities may be available. Suggests and develops high-quality, high-value concepts and or process improvements, tools, etc. • Integrates medical chart coding principles, clinical guidelines, and objectivity in performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. • Audits inpatient medical records and generates high-quality claims payment to ensure payment integrity. • Performs clinical reviews of medical records and other utilization management documentation to evaluate issues of coding and DRG assignment accuracy. • Collaborates and/or leads special projects. • Influences and engages team members across functional teams. • Facilitates and provides support to other team members in development and training. • Develops and maintains job aids to ensure accuracy. • Escalates claims to medical directors, health plans and claims teams, and collaborates directly with a variety of leaders throughout the organization. • Facilitates updates or changes to ensure coding guidelines are established and followed within the health Information management (HIM) department and by National Correct Coding Initiatives (NCCI), and other relevant coding guidelines. • Ensures care management and Medicaid guidelines around multiple procedure payment reductions and other mandated pricing methodologies are implemented and followed. • Supports the development of auditing rules within software components to meet care management regulatory mandates. • Utilizes Molina proprietary auditing systems with a high-level of proficiency to make audit determinations, generate audit letters and train team members. Required Qualifications • At least 3 years clinical nursing experience in claims auditing, quality assurance, recovery auditing, DRG/clinical validation, utilization review and/or medical claims review, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in the state of practice. • Experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria and coding terminology. • Strong knowledge in coding: DRG, ICD-10, CPT, HCPCS codes. • Excellent verbal and written communication skills. • Extensive background in either facility-based nursing and/or inpatient coding, and deep understanding of reimbursement guidelines. • Ability to work cross-collaboratively across a highly matrixed organization. • Strong verbal and written communication skills. • Microsoft Office suite proficiency (including Excel), and applicable software program(s) proficiency. Preferred Qualifications • Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA). • Claims auditing, quality assurance, or recovery auditing, ideally in DRG/clinical validation. • Training and education experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $76,425 - $149,028 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Molina Healthcare

Medical Review Nurse (RN)

Job Description Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. Job Duties Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. Reevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement to providers. Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience. Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings. Reviews medically appropriate clinical guidelines and other appropriate criteria with medical directors on denial decisions. Supplies criteria supporting all recommendations for denial or modification of payment decisions. Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals. Provides training and support to clinical peers. Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. Job Qualifications REQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice. Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). Experience working within applicable state, federal, and third-party regulations. Analytic, problem-solving, and decision-making skills. Organizational and time-management skills. Attention to detail. Critical-thinking and active listening skills. Common look proficiency. Effective verbal and written communication skills. Microsoft Office suite and applicable software program(s) proficiency. PREFERRED QUALIFICATIONS: Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. Billing and coding experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $29.05 - $67.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Molina Healthcare

Medical Review Nurse (RN) Remote, 8:30am-5:00pm Central Time Zone

$29.05 - $67.97 / hour
{ 'title' : 'Bad Request', 'status' : '400', 'o:errorDetails' : [ { 'detail' : 'URL request parameter onlyData cannot be used in this context.', 'o:errorCode' : '27520' } ] } Pay Range: $29.05 - $67.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Molina Healthcare

Care Review Clinician (RN)

$26.41 - $61.79 / hour
JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines. • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. • Requests additional information from members or providers as needed. • Makes appropriate referrals to other clinical programs. • Collaborates with multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.