Nursing Jobs in Baldwin Park, 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 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) 
$93,100 - $146,000 / year
Posting Date 03/09/2026 10211 Long Beach Blvd, Lynwood, California, 90262-1508, United States of America As a Healthcare Operations Manager (Facility Administrator) at DaVita, you’ll be a part of a Team that values work-life balance and where your personal and professional growth is a top priority. DaVita has an open position for a Healthcare Operations Manager (Facility Administrator) who must be an ambitious, operationally-focused and results-driven leader. You will directly impact patient care as the trusted front-line leader in an outpatient clinic setting. Health care experience is not required! What you can expect as a Healthcare Operations Manager: Patients come first. You have an opportunity to build on your relationship with your patients, while also continuously improving their health through clinical goal setting and quality improvement initiatives. Meaningful Workday - EVERY Day. You'll go home every day knowing you are making a difference in patients' lives and that you are developing your team to reach their full potential. Available when the clinic is open. Lead a Team. Develop, mentor and inspire a cross-functional clinical team (census dependent on state laws) to deliver the best for our patients, teammates and community. Financial Management. Manage complete operation and performance of the clinic: adhere to budget, forecast expenses, manage vendor relationships, order supplies, and monitor compliance. Autonomy. It's your clinic to run. You aren't alone though. You will have the support and guidance of your director, regional peers and the greater company to help you manage your facility. We foster entrepreneurs and those who seek to continuously improve. Culture & Growth. Our values are not just written in a book somewhere, but are an intentional part of everything we do. As leaders, you are able to reward others for demonstrating those shared beliefs and behaviors, and in turn, we intend to do the same for you. Partner with Regional Operations Director to identify and address employee and patient concerns to drive towards Regional goals and standards Now is your time to explore your next journey—at DaVita. What you can expect: Lead a Team that appreciates, supports and relies on each other in a positive environment. Performance-based rewards based on stellar individual and team contributions. What we'll provide: DaVita is a clinical leader! We have the highest percentage of facilities meeting or exceeding CMS's standards in the government's two key performance programs. We expect our nurses to commit to improving patient health through clinical goal-setting and quality improvement initiatives. Comprehensive benefits: DaVita offers a competitive total rewards package to connect teammates to what matters most. We offer medical, dental, vision, 401k match, paid time off, PTO cash out, paid training and more. DaVita provides the opportunities for support for you and your family with family resources, EAP counseling sessions, access to Headspace®, backup child, elder care, maternity/paternity leave, pet insurance and so much more! Requirements: Associate's degree preferred, unless required by the state; Bachelor's degree in related area strongly preferred Minimum of one year experience required in management (healthcare, business, or military) or equivalent renal experience (nurse, dietitian, social worker, LPN, etc.) at discretion of DVP and/or ROD Current license to practice as a Registered Nurse if required by state of employment Current CPR certification required (or certification must be obtained within 60 days of hire or change in position) Other qualifications and combinations of skills may be considered at discretion of ROD and/or Divisional Vice President Collaboration is a much to be successful in this role. You will be working with clinical and financial teams on a daily basis to produce results that align to business needs. Intermediate computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required. Now is your time to join Team DaVita. Take the first step and apply now. #LI-HM1 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. The Salary Range for the role is $93,100 - $146,000 per year. For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information. 
$133,120 - $219,648 / year
The Assistant Nurse Manager, in collaboration with and under the direction of the Department Nurse Manager, is accountable for ongoing leadership and operations of the assigned area(s) and for nursing care safety and quality. The Assistant Nurse Manager uses sound human resource and budget principles to guide the daily provision of nursing services to patients and families. The Assistant Nurse Manager participates in organizational and unit-based quality improvement activities and provides input on standard of care. The Assistant Nurse Manager supports comprehensive patient and family services through effective participation with the interdisciplinary team. Essential Duties: 1. Collaborates with the Department Nurse Manager to provide leadership for nursing staff and the interdisciplinary patient care team to support high quality care of patients and families (as evidenced by increased patient satisfaction, decreased HAI, staff conversation records/disciplines, incident report follow ups completed in a timely manner and other measures as applicable). a. Acts as a role model and steward to the shared vision, mission, values, and service excellence standards of the organization and the Department of Nursing, demonstrating application of the Professional Practice Model. b. Instill the Keck values in staff and holds them accountable to the standards set for service excellence and the professional practice of nursing. c. Maintains positive and collaborative professional relationship with peers, management, physicians and patients/families to ensure patient-centered care. d. Shares responsibility for nursing process and outcomes, providing staff performance coaching for process and quality improvement, including the development of action plans through shared-governance committees/councils. e. Encourages staff to provide input and make decisions supported by evidenced-based practice to improve patient and family care and the work environment. f. Provide opportunities to Involves staff in projects, conferences, professional certification, and educational advancement that encourage and provide professional growth and development. g. Oversees performance management, including developing individualized action plans to support staff development to meet or exceed quality, performance and organizational goals. h. Promotes cohesive work teams and constructive conflict resolution, actively supporting intra- and inter-professional teamwork, within the department. i. Maintains knowledge of federal, state and local regulatory requirements that impact clinical services and professional practice to ensure efficient quality of care is provided and is in compliance with established organizational goals. j. Maintains clinical competence (serve as Super user as needed) k. Addresses quality of care concerns and Intervenes to ensure a safe environment for patients and staff up to and including comprehensive review of reportable events. l. Supervises care provided by maintaining high visibility and accessibility to patients/families and staff in the clinical area(s) through purposeful staff and patient rounding with timely follow-up on quality, performance and behavioral issues. m. Monitors staff compliance with bedside reporting. n. Information for patients and staff is delivered in a manner that is supportive, timely, and understandable. o. Provides coverage for department manager in addition to coverage for other departments in their absence. p. Timely completion of incident report follow ups (SRMs) 2. Collaborates with the Department Nurse Manager to provide the personnel, workplace, and technology resources necessary for the provision of safe, high Department quality patient and family care (as evidenced by competencies completed, staff satisfaction, completion and improvement of audits, decreased staff delinquencies and other measures as applicable). a. Oversees daily department operations in collaboration with the department leadership team, staff, and interdisciplinary stakeholders to include the supervision and coordination of patient assignments based on staff competency and level of acuity. b. In collaboration with departmental shared-governance committees, utilize the departmental staff engagement survey to develop actions plans to improve the workplace. c. Provides input to Department Nurse Manager for additional, different, and/or new personnel, workplace, and technology resources. d. Assists with recruitment, personnel selection and conduct interviews. Submits new hire / transfer paperwork as well as prepares orientation schedules for full-time, part-time, per diem and contract staff. Also validates, monitors, and evaluates orientation process in collaboration with educator/CNS. e. Conducts timely 90-day and annual evaluations for staff -and participate in staff interviews, setting clear staff performance expectations, including the administration of first step progressive discipline and up to the second step in collaboration with the Department Nurse Manager. f. Monitors the adequacy of supplies and equipment necessary for patient care, adjusting the par level and advocating for additional supplies when needed. g. Provides input to the technology resources available for patient care, seeking staff input during the decision making and selection processes, as well as during ongoing use. h. Demonstrates reflective leadership and uses self appraisal, performance appraisal, Department Manager input, and peer review to assist with professional development. i. Maintains membership in at least one professional organization, participating on key practice issues. j. Maintains all records and oversees the completion by staff of mandatory competencies to meet regulatory requirements, ensures on-going adherence, and monitors for compliance in collaboration with Educator. k. Monitors compliance with clinical documentation and quality reports to include but not limited to narcotic counts, hand-hygiene compliance, HAI, medication errors, etc and conduct timely follow-up as needed. l. Ensures timely completion of all employee work related injury reports and follow through to completion. m. Participate and respond to Code Triage. 3. Collaborates with the Department Nurse Manager with the application of new knowledge and innovation to advance improvements at the department level (as evidenced by staff satisfaction scores, staff involvement in meetings and quality committees and other measures as applicable). a. Provides constructive input and contributes to department and organizational planning as it relates to education programs, in-services, meetings, committees, and professional initiatives. b. Leads staff meetings and/or shift huddles as directed by Nurse Manager. c. Shares responsibility for the outcomes of quality improvement initiatives, contributes to improvement efforts, and champions change by identifying obstacles and requesting resources for effective improvement programs. d. Utilizing the JUST culture and in collaboration with department manager, review and investigation events identified through reporting system and provide staff education and / or performance management up to written disciplinary action as needed. e. Contribute towards staff awareness of departmental and organizational updates and changes by ensuring that daily huddle boards are updated and assisting department manager with preparation of the departmental weekly updates. Contributes to policy and procedure development and updates. f. Plans and coordinates with Nurse Educator/CNS the educational classes/courses required for the department, including but not limited to annual skills, department skills, point-of-care and competency validation testing. g. Supports staff participation in continuous improvement efforts and facilitates their contribution. h. Makes a measurable commitment to personal professional development in order to adapt effectively to ongoing change and coach and mentor staff to do the same. 4. Collaborate with the Department Nurse Manager to effectively manage the department operating budget, identifies and recommends capital expenditures, and plans new programs or services (as evidenced by HPPD, decreased overtime and doubletime, decreased missed meals and completion of DSR/variance report and other measures as applicable). a. Evaluates the efficiency of department daily operations and supports cost-effective resource utilization and financial outcomes through the monitoring of meal periods, incidental overtime, contract hours and compliance with organizational and departmental attendance and punctuality standards. Keeps Department Manager aware of trends and ensure performance management (up to written disciplinary action) as needed. b. Ensures adequate daily staffing and department schedules are managed within budgetary standard. Authorizes overtime or scheduling changes as needed. c. Prepares, approves and posts final schedule in collaboration with Nurse Manager. d. Approves vacation schedule in accordance with departmental and organizational standards. e. Coaches and mentors department staff to make cost effective decisions and use resources prudently as it relates to supplies, scheduling practices and compliance with organizational and departmental timekeeping standards. f. Accurately and efficiently completes daily edits in Kronos to assure compliance with organizational and department standards. g. Facilitates the management of patient flow with admissions, discharges and/or transfers. h. In partnership with department manager will review and ensure accuracy of charge reconciliation. 5. EMPLOYEE PARTNERSHIP SURVEY a. Shows improvement in unit participation in the annual Employee Partnership Survey (Press Ganey). b. Shows improvement in unit overall Partnership Score (Press Ganey). 6. QUALITY AND SAFETY (compared to UHC benchmark as applicable) a. CLABSI b. CAUTI c. HAPU d. Patient Falls e. Core Measures 7. PATIENT EXPERIENCE a. HCAHPS Score – Communication with Nurses b. HCAHPS Score – Response of Hospital Staff c. HCAHPS Score – Hospital Environment: Quietness d. HCAHPS Score – Pain Management e. HCAHPS Score – Communication About Medications f. HCAHPS Score – Discharge Information Performs other duties as assigned. Required Qualifications: Req Bachelor’s Degree Nursing Degree in Nursing (BSN). Req 3 years RN experience. Req Strong critical and strategic thinking, analytical and planning skills. Req Organization/time management skills. Req Excellent communication skills. Req Values diversity and team work. Req Demonstrates integrity; is ethical in conduct and decision thinking. Req Demonstrates initiative, creativity and flexibility and is tolerant of change and ambiguity. Req Demands accountability of self and others. Req Proficient computer skills in Microsoft Office as well as Internet access and utilization Preferred Qualifications: Pref Master’s degree Nursing Master’s Degree in Nursing or in progress, strongly preferred* Master’s Degree in Nursing may be in lieu-of Bachelor’s Degree in Nursing. Pref Specialty Certification Required Licenses/Certifications: Req Registered Nurse - RN (CA Board of Registered Nursing) Valid California RN License. Req Basic Life Support (BLS) Healthcare Provider from American Heart Association Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only) Req Advanced Cardiovascular Life Support (ACLS) Healthcare Provider from American Heart Association The annual base salary range for this position is $133,120.00 - $219,648.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position for which you are applying. We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at uschr@usc.edu . Inquiries will be treated as confidential to the extent permitted by law. Notice of Non-discrimination Employment Equity Read USC’s Clery Act Annual Security Report USC is a smoke-free environment Digital Accessibility If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser: https://wd5.myworkday.com/usc/d/inst/1$9925/9925$142348.htmld 
