Nursing Jobs in Garden Grove, CA

RN Telemetry Full-time
Prime Healthcare

Registered Nurse (RN) - Telemetry

apartment Prime Healthcare location_onAnaheim, CA
Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! West Anaheim Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Founded in 1964, West Anaheim Medical Center is a 219-bed acute-care hospital dedicated to providing the community with high-quality, compassionate healthcare. Key services include general medical and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more information visit www.westanaheimmedctr.com. 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 Telemetry Unit. The Registered Nurse is directly responsible and accountable for the care given to their assigned patients. They communicate with the 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. Basic Arrythmia Interpretation within 30 days of hire. 4. Current ACLS certificate 30 days upon hire and maintain current. 5. Previous Acute Care hospital experience preferred. 6. Ventilator Management experience preferred. 7. Medical-Surgical Nurse-Board Certified (RN-BC) or similar certification; preferred. 8. Bachelor of Science in Nursing (BSN) preferred. Pay Transparency West Anaheim 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 $48.58 to $65.31. 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
CMA Outpatient Full-time
WVUH West Virginia University Hospitals

Ambulatory Care Asst - MA - Dermatology - University Town Centre

apartment WVUH West Virginia University Hospitals location_onUniversity Town Center, CA
Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. Perform various duties related to patient care and treatment as directed by attending providers in an outpatient clinic setting. Provide clerical and clinical support to medical staff in assigned unit. MINIMUM QUALIFICATIONS : EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High school diploma or equivalent. 2. Graduate of a Medical Assistant Program OR graduate of the Med Ed Program OR one (1) year of clinical experience. 3. Obtain certification in Basic Life Support within 30 days of hire. 4. State criminal background check and Federal (if applicable), as required for regulated areas PREFERRED QUALIFICATIONS : EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Registration or Certification as a medical assistant. EXPERIENCE: 1. One (1) year experience as a Medical Assistant or patient care. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Provide support to medical staff to assure patients' needs are met and to assure efficient operation of outpatient unit. 2. Assist providers when possible in completing requisitions or forms for patient examination or testing. May assure availability of test results for patient visits. Assist patients and providers with medical office visits. 3. Administer prescribed medication under supervision of attending provider. 4. Perform qualitative and quantitative tests and examinations of specimens. 5. Obtain and document patients’ specimens as ordered. 6. Documents and reports test results to medical provider. 7. After training and skills testing may perform assigned and/or all ordered POCT tests and maintain quality control testing and logs. 8. Schedules additional ancillary testing as needed. Assists providers when possible in completing requisitions or forms for patient examination or testing. 9. Act as chaperone during medical examinations. 10. Ensure medical records and test results are available for visit, including those from referring physicians. Inspect/review medical records to maintain correct order and completeness. 11. Monitors nurse call system and relays information to appropriate staff telephone calls and transmits information to appropriate staff. 12. Provides assistance and information to patients, families, and visitors as instructed by the physician. 13. Participates in Quality Assurance Program to assure quality patient services are provided. 14. Generate required patient charge data according to WVU Medicine outpatient procedures. 15. Assist in maintaining appropriate inventory of supplies and equipment for patient care needs by preparing orders and reporting needs to supervisor. Demonstrate knowledge of use and care of all equipment including printers, embossers, and computers. 16. Assist with maintenance of inventory and equipment on assigned outpatient unit. 17. May schedule and coordinate new and return appointments using computerized system according to WVU Medicine outpatient clinic policy and procedures. Schedule and coordinate diagnostic and/or therapeutic procedures. 18. May assure registration of patients. Collect vital information for purposes of patient identification and billing purposes and enter data into computer. Obtain charts and fee sheets necessary for patient visits. Obtain signatures from release of information and consent to treatment. 19. May assist Registration Specialist with deposit of money and with late night coverage. May assist Manager/Supervisor with unit correspondence using computer software. 20. May process and mail letters to patients. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Work requires strength and/or stamina, lifting, moving, stooping, reaching, standing, walking, and carrying of materials and equipment weighing 40+lbs. 2. Must be able position and/or lift patients, and stand or walk 4 to 12 hours per day. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Work is performed in a normal clinical outpatient environment. 2. Position is frequently exposed to biohazards, as well as communicable disease. 3. Position requires ability to respond quickly to varying demands from provider and patient. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: WVUH West Virginia University Hospitals Cost Center: 8876 WVUH Medicine Dermatology UTC Address: 6040 University Town Center Drive Morgantown West Virginia Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.
CNA Telemetry Full-time
PIH Health

Certified Nurse Assistant (CNA), 4 Plaza Post-Surgical Telemetry, Full Time, Nights

apartment PIH Health location_onWhittier, CA
Facilitates the provision of timely and effective patient care under the supervision of licensed members of the healthcare team. Helps maintain a safe and clean environment in order to enhance department operations. Patient care is delivered consistent with the model and philosophy of relationship based care. 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 English communication skill Basic organizational skills Knowledge of medical terminology Knowledge of infection control Able to work using aseptic techniques Required Experience Required: Current California CNA certification is required. Evidence of continuing education where required. Current Basic Life Support Care Preferred: Prior experience in acute facility Basic windows and mouse skills Address 12401 Washington Blvd. Salary 21.50-34.50 Shift Nights Shift Differential 1.93 Zip Code 90602
CMA Outpatient Full-time
PIH Health

Medical Assistant (MA) Family Medicine

apartment PIH Health location_onWhittier, CA
The Medical Assistant works under general supervision to perform a variety of procedures; fills in and performs various patient-specific job duties; must have knowledge of each clinical task assigned; must keep updated on any changes made within the Medical Assistant scope of practice. The Medical Assistant may be requested to float between departments and periodically travel; process all outside referrals including HMO and PPO, maintaining accurate records and notifying all concerned parties of the outcome as required. 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 With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient and significant other when administering care. Candidate must be able to work in a fast-paced environment which may include a considerable amount of walking, and physical assistance for patients. Strong verbal and written skills; fluent in English. Knowledge of medical terminology, infection control and patient safety measures. Current AHA BLS certification required. Adaptability and accuracy. Must have good visual acuity and motor coordination. Strong clinical skills. Basic math skills and ability to handle cash transactions. Strong computer skills (data entry and typing). Honest, dependable, and conscientious. Knowledge of Electronic Health Record (EHR) computerized practice management and other record keeping systems. Bilingual, Spanish preferred. Required Experience Formal training will be indicated by a high school diploma or equivalent and graduation certificate from an accredited Medical Assistant program. In circumstances of a practice acquisition, a competency validation must be completed by a PIH Health supervising physician whose practice we are acquiring. Must have no less than 10 years’ experience with said physician/practice. Minimum six (6) months of front and back medical office experience required. Two (2) years of front and back medical office experience preferred. Must possess a valid California Driver’s License if hiring into Medical Assistant Float Pool Ability to maintain composure when confronted with fast paced situations, excellent communication skills; ability to work in an environment involving a high level of activity and a variety of positions. Address 12522 Lambert Rd. Salary 21.25-32.00 Shift Days Zip Code 90606
CNA Telemetry Per Diem
PIH Health

Certified Nurse Assistant (CNA), Telemetry, Resource Pool, Nights

apartment PIH Health location_onWhittier, CA
Facilitates the provision of timely and effective patient care under the supervision of licensed members of the healthcare team. Helps maintain a safe and clean environment in order to enhance department operations. Patient care is delivered consistent with the model and philosophy of relationship based care. 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 English communication skill Basic organizational skills Knowledge of medical terminology Knowledge of infection control Able to work using aseptic techniques Required Experience Required: Current California CNA certification is required. Evidence of continuing education where required. Current Basic Life Support Care Preferred: Prior experience in acute facility Basic windows and mouse skills Address 12401 Washington Blvd. Salary 21.50-34.50 Shift Nights Zip Code 90602
RN Full-time
ScionHealth

Registered Nurse - Full Time Days

apartment ScionHealth location_onParamount, CA
Description At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Provides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation. Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary. Communicates changes in patient’s clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning process. Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, provides and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member’s capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient’s medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team Assesses and reassesses pain Utilizes appropriate pain management techniques Educates the patient and family regarding pain management Revises the plan of care as indicated by the patient’s response to treatment and evaluates overall plan daily for effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient’s age Receives physician’s orders, ensures transcription is accurate and documents completion Administers medication utilizing the five rights of medication administration reducing the potential for medication errors Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to level of licensure Treats patients and their families with respect and dignity Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers. Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient’s status to identify each patient’s age specific needs and provide care needed by the patient group Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients’ condition Answers telephone, paging system, patients’ call lights, anticipates patients’ needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient’s needs Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Knowledge/Skills/Abilities/Expectations Knowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0% Must read, write and speak fluent English Must have good and regular attendance Performs other related duties as assigned Salary Range: $44.38 - $55.18/Hour ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness. Qualifications Education Graduation from an accredited Bachelor of Science in Nursing Associate Degree in Nursing or Nursing Diploma program Licenses/Certification Current state licensure as Registered Nurse BCLS certification required ACLS certifications preferred Experience Minimum six months’ Medical/Surgical experience in an acute care setting preferred
NP Full-time
AltaMed

Nurse Practitioner, Geriatric

apartment AltaMed location_onHuntington Park, CA
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 Nurse Practitioner provides medical services to clients, ensuring appropriate and professional medical services. Minimum Requirements Graduation from an accredited Baccalaureate school of nursing. Completed training in the diagnosis and management of common and some complex medical conditions. Current licensure in the State of California. Certification as an Adult/Family/Pediatric/Women’s Health Nurse Practitioner. Previous experience with computer-based systems is required; Electronic Medical Records experience is preferred. 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 $160,680.00 annually 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.
RN ICU Per Diem
MemorialCare

Registered Nurse (RN), ICU

apartment MemorialCare location_onAliso Viejo, CA
Title: Registered Nurse (RN) Location: Saddleback Medical Center Department: Intensive Care Unit Status: Per-diem Shift: Nights 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 This position requires the full understanding and active participation in fulfilling the mission of Saddleback Medical Center. It is expected that the employee demonstrate behavior consistent with our core values: Integrity, Accountability, Best Practices, Compassion and Synergy. The employee shall support Saddleback Medical Center’s strategic plan and participate in and advocate performance improvement/patient safety activities. Utilizing the nursing process and clinical nursing practice standards, the RN is responsible for directing and coordinating nursing care for the patient within the Intensive Care Unit in accordance with the policies and procedures of the Nursing Department. Responsibilities include directing unlicensed employee activity, synthesizing patient information, assessment of patients, planning of care /interventions, teaching patients/family, implementation of treatment plan/MD orders, and evaluation of care rendered. The RN must effectively communicate and document data relevant to the care of the patient. The RN utilizes knowledge of patient age, cultural diversity, and psychosocial and/or spiritual needs into the patient’s plan of care. The RN contributes to the promotion of quality nursing care through performance improvement processes that demonstrates positive outcome in patient care. In addition, the RN collaborates with other professional disciplines to ensure safe and effective patient care delivery and the achievement of desired patient outcome. Essential Functions and Responsibilities of the Job Utilizes the nursing process and practice standards as a framework for the management of patient care. Analyzes the assessment data to determine a nursing diagnosis and appropriate interventions. Demonstrates the ability to utilize effective critical thinking skills. Demonstrates leadership in the coordination of patient care across the healthcare continuum with progress towards meeting desired patient outcome. Delegates to licensed and unlicensed personnel. Demonstrates knowledge of the clinical information system and applies principles to patient documentation. Formulates a teaching plan, based on identified patient learning needs, and evaluates effectiveness of learning; family is included in teaching plan as necessary. Serves as a role model and mentors new staff members. Demonstrates the ability to integrate knowledge of job specific competencies. Identifies, develops and implements an action plan for self-development/professional growth that also includes peer review. Identifies subtle as well as obvious patient problems and reports to an appropriate resource person considering multidisciplinary team members and/or Chain of Command. Addresses the age specific needs of all populations served: adolescent, adult, and geriatric. Contributes to an effective and safe working environment. Demonstrates tact, sensitivity and discretion in order to maintain good relations with others. Ability to be at work and be on time. Ability to follow company policies, procedures and directives. Ability to interact in a positive and constructive manner. Ability to prioritize and multitask *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 Utilization Review Full-time
Molina Healthcare

Medical Review Nurse (RN)

apartment Molina Healthcare location_onLong Beach, CA
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.
RN Full-time
CVS Health

Case Manager RN- Field

apartment CVS Health location_onLos Angeles, CA
$54,095 - $116,760 / YEAR
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Coordinates all case management activities with members to evaluate medical needs and to facilitate the overall wellness of members. Develops strategy to address issues to outcomes and opportunities to enhance member's overall wellness through integration. Instructs programs and procedures in compliance with network management and clinical coverage policies. Required Qualifications Must reside in Louisiana in one of the following parishes: Plaquemines, Jefferson, Orleans, St. Bernard, West Feliciana, East Feliciana, Pointe Coupee, West Baton Rouge, East Baton Rouge, Iberville, Ascension, St. Mary, Assumption, St. James, Terrebonne, Lafourche, St. Charles, St. John, Winn, Grant, Rapides, Vernon, LaSalle, Avoyelles, Catahoula, Concordia, Union, Lincoln, Jackson, Morehouse, Ouachita, Caldwell, West Carroll, Richland, Franklin, East Carroll, Madison, Tensas, St. Helena, Livingston, Tangipahoa, St. Tammany, Washington Registered Nurse with current unrestricted Louisiana (LA) license 3+ years’ clinical practice experience as an RN 1+ years' Case management and discharge planning experience Must possess reliable transportation and be willing and able to travel, up to 75% or more of the time. Mileage is reimbursed per our company expense reimbursement policy. Proficiency with MS Office Suite (Outlook, Word, Excel, SharePoint, Teams), EMR systems, and multi-system navigation. Strong organizational skills with attention to detail, quality, and time management. Demonstrated ability to build and sustain a positive work culture that promotes engagement. Mastery in problem-solving, decision-making, collaboration, and execution. Knowledge of care transition phases and available member resources. Digital literacy and ability to leverage technology for operational efficiency. Preferred Qualifications · Medicaid experience · Behavioral health experience · Managed care/utilization review experience · Waiver experience · Crisis intervention skills · Certified Case Manager (CCM) certification · Familiarity with EMR Education · Associate’s degree in nursing required · BSN preferred Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $116,760.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan . No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 02/28/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
CNA Full-time
ScionHealth

Certified Nurse Assistant CNA Full Time Days

apartment ScionHealth location_onWestminster, CA
Description At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Assists professional nursing personnel in providing patient care in assigned area. Assists patients with activities of daily living, provides for personal care, emotional support and performs more complex clinical skills under the direction of professional nursing personnel. Essential Functions Consults with and keeps supervisor informed of unit activities, needs, and problems related to patient care Provides general nursing care such as positioning the patient, lifting, turning, applying/utilizing special equipment, assisting in the use of bed pan, urinal or commode, ambulating the patient, pre operative and post operative care, and application of binder or anti embolic stockings, bed bath, oral/hair/back care, changing bed linens, cleaning over bed table, and bedside stand, straightening patient room and other general care necessary during the shift Takes and records temperature, pulse, respiration, weight, height, blood pressure, and intake and output measurements accurately. Documents in a timely manner. Prepares patient room and bed for admission and transfers and ensures all necessary equipment is in room Maintains an attractive and comfortable environment for patients with special consideration to cleanliness of room, ventilation, and lighting Assists in patient admission, transfer, and discharge procedures Assist with handling and care of patient belongings and other personal property Answers patient call lights, telephone, and paging system and responds as appropriate Under the direction of the Registered Nurse, performs routine treatment procedures such as enemas, application of appliances for heat and cold Able to release, remove, and reapply restraints to patient under the direction of an RN Ensures patient is in proper position and alignment Assist Registered Nurse and/or LVN/LPN with complicated patient treatment procedures Serves and removes patient meal tray in timely manner Assists with feeding and/or preparing items such as opening milk container, cutting food for patient Knowledge/Skills/Abilities/Expectations Must read, write and speak fluent English Must have good and regular attendance Excellent oral and written communication and interpersonal skills Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0% Performs other related duties as assigned Pay Range: $21.00 - $24.47/Hour ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness. Qualifications Education Completion of course for nursing assistants Licenses/Certification Current Nursing Assistant Certification BLS Certification Experience Minimum six months’ experience in acute or long-term care facility
CNA Full-time
ScionHealth

Certified Nursing Assistant CNA Full Time Nights

apartment ScionHealth location_onWestminster, CA
Description At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Assists professional nursing personnel in providing patient care in assigned area. Assists patients with activities of daily living, provides for personal care, emotional support and performs more complex clinical skills under the direction of professional nursing personnel. Essential Functions Consults with and keeps supervisor informed of unit activities, needs, and problems related to patient care Provides general nursing care such as positioning the patient, lifting, turning, applying/utilizing special equipment, assisting in the use of bed pan, urinal or commode, ambulating the patient, pre operative and post operative care, and application of binder or anti embolic stockings, bed bath, oral/hair/back care, changing bed linens, cleaning over bed table, and bedside stand, straightening patient room and other general care necessary during the shift. Takes and records temperature, pulse, respiration, weight, height, blood pressure, and intake and output measurements accurately. Documents in a timely manner. Prepares patient room and bed for admission and transfers and ensures all necessary equipment is in room Maintains an attractive and comfortable environment for patients with special consideration to cleanliness of room, ventilation, and lighting. Assists in patient admission, transfer, and discharge procedures Assist with handling and care of patient belongings and other personal property Answers patient call lights, telephone, and paging system and responds as appropriate Under the direction of the Registered Nurse, performs routine treatment procedures such as enemas, application of appliances for heat and cold Able to release, remove, and reapply restraints to patient under the direction of an RN Ensures patient is in proper position and alignment Assist Registered Nurse and/or LVN/LPN with complicated patient treatment procedures Serves and removes patient meal tray in timely manner Assists with feeding and/or preparing items such as opening milk container, cutting food for patient Knowledge/Skills/Abilities/Expectations Must read, write and speak fluent English Must have good and regular attendance Excellent oral and written communication and interpersonal skills Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0% Performs other related duties as assigned Pay Range: $21.00 - $24.47/Hour ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness. Qualifications Education Completion of course for nursing assistants Licenses/Certification Current Nursing Assistant Certification BLS Certification Experience Minimum six months’ experience in acute or long-term care facility
RN Full-time
Dignity Health

RN IRF COORDINATOR

apartment Dignity Health location_onLong Beach, CA
Job Summary and Responsibilities At St. Mary Medical Center, this position reports directly to the Rehabilitation Unit Director and will be under the direction of the Medical Director of Rehabilitation. The Rehabiliation Clinical Liason will adhere to the collective needs of consumers with physical injuries/disabilities and medical conditions impairing functional abilities. This position requires a working knowledge of Title 22, Prospective Payment System (PPS), and Insurance’s/Vendors/Negotiation for service and contracts. This position will focus on census building, community outreach, and program development. The Rehabilitation Clinical Liaison is responsible for maintaining current referral sources and for developing new clients in order to create a significant referral base for maintaining a set inpatient population. The Rehabilitation Clinical Liaison, in consultation with St. Mary Medical Center physicians, is also responsible for the completion of appropriate pre-screening documentation. Job Requirements Current clinical licensure RN. Working knowledge of rehabilitation interdisciplinary team model. Five years clinical rehabilitation experience. One year of direct clinical liaison exprience. Understanding of Medicare guidelines for admission, CMS 13 compliance, and the Medicare 60% rule. Computer literate. Where You'll Work CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community. One Community. One Mission. One California
LVN Psych Full-time
Stars Behavioral Health Group

Licensed Vocational Nurse/ License Psychiatric Technician

apartment Stars Behavioral Health Group location_onCity of Industry, CA
$28 - $30 / HOUR
Partner with us in making a positive change! Join a team where your work truly matters. We're proud to have been certified as a Great Place to Work for 8 years by our own employees. We invite you to partner with us in our mission to improve mental healthcare. Job Title: Licensed Vocational Nurse/ License Psychiatric Technician Division/Program: City of Industry - Behavioral Health Urgent Care Center Starting Compensation: 28.00 - 30.00 USD Per Hour Working Location: City of Industry, CA Working Hours/Shift: SAT - MON: 7 AM - 7:30 PM Why Join Our Team? Competitive Compensation : Offering a salary that matches your skills and experience. Generous Time Off : Enjoy ample vacation and holiday pay. Comprehensive Benefits Package : Employer-paid medical, dental, and vision coverage. Additional voluntary benefits to support your lifestyle. Professional Growth Opportunities : On-the-job training with access to paid CEU opportunities. Career development programs designed to help you grow. Supervision for BBS hours for AMFT, ACSW, and APCC professionals (where applicable). Employee Recognition & Rewards : A culture that celebrates and rewards your hard work and dedication What you bring to SBHG (qualifications) : Graduation from an accredited school of licensed vocational nursing or psychiatric technology, Associate degree preferred Minimum of one (1) year of experience treating the mentally ill in an inpatient setting Minimum of one (1) year of medication administration experience Valid California LVN or LPT license Valid California Driver's License preferred How you will make a difference (job overview): The LVN/LPT provides direct client care including medications. Maintains vigilance over the general milieu within the facility to facilitate quality client care, optimum facility operations and preserve the safety of all therein. Visually and audibly observes, documents in writing and reports orally or in writing the physical or mental condition of patients to the Registered Nurse in charge of the facility on the shift and the attending physician. Orders, prepares, administers and documents the administration of medication for clients according to physician’s orders. Confirms delivery of all ordered medication(s) from pharmacy on shift worked. Responsible for writing summary on clients as assigned. Makes written or oral shift assignments and plans, organizes and directs the nursing activities of the unit (when needed and assigned) to assure quality care delivery. Division/Program Overview: 24/7 outpatient program Rapid mental health assessment, crisis intervention, and medication support Walk-in’s welcome Clients may stay up to 24 hours BHUCC equipped to serve 12 adults (ages 18 and up) and 6 adolescent (ages 13 to 17) Learn more about SBHG at : https://www.starsinc.com/stars-inc/ For Additional Information: Jerevilla@starsinc.com In accordance with California law, the grade for this position is 27.07 - 43.31. Placement within the grade is determined based on experience, internal equity, and other factors permitted by law.
RN Telemetry Full-time
Dignity St. Mary Medical Center

RN Telemetry

apartment Dignity St. Mary Medical Center location_onLong Beach, CA
Job Summary and Responsibilities As a Telemetry Nurse at St Mary Medical Center, you’ll put your nursing skills and knowledge to the test as you closely monitor your patients’ vitals like blood pressure, oxygen saturation, heart rhythms, and respiration. You’ll also put patients and their loved ones at ease by explaining test results in a way they can understand and make significant healthcare decisions. Each day you’ll serve as a key member of our nursing team by working with our doctors and other clinical specialists to closely observe patients requiring continuous cardiac monitoring. You’ll build trust in these interactions by learning new concepts and applying what you know in real-time to provide solutions for real people. Your success in this role comes from your enthusiasm to provide great care, learn new things, and ability to communicate effectively with peers, patients, and patients' loved ones. Track routine heart rate, blood pressure, and pulse ox levels Quickly report and address any changes in condition Patiently and thoroughly explain tests results and procedures to patients and family members Educate patients on post-hospital care, including prescribed medicine, care maintenance, and prevention While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, and more! Job Requirements Current license as a Registered Nurse in the State of California. Current basic life support (BLS) certification Current advanced cardiac life support (ACLS). Minimum of one year Acute Care RN experience. Completion of a Telemetry class preferred Completion of EKG interpretation class preferred Successful completion of a medication examination and satisfactory completion of department/unit specific orientation. Where You'll Work CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community. One Community. One Mission. One California
NP Part-time
Ageless Men's Health

Physician Assistant (PA-C) or Nurse Practitioner (NP), per diem

apartment Ageless Men's Health location_onSeal Beach, CA
Physician Assistant (PA-C) or Nurse Practitioner (NP) – Men’s Health Clinic | Ageless Men’s Health Location: Seal Beach, CA Schedule: Monday–Friday, as needed | No nights, weekends, or on-call Job Type: Per Diem, On-Site/In-Person Pay: $67 hourly rate Foster real relationships. Advance the cause of men’s health. Improve lives. With more than 90 clinics nationwide and a rapidly growing patient base, Ageless Men’s Health is seeking an experienced and compassionate Physician Assistant (PA-C) or Nurse Practitioner (NP) to join our clinical team in Seal Beach, CA . At Ageless, we focus on medically managed testosterone replacement therapy (TRT) , weight management , skin care , and concierge medicine — helping men look better, feel better, and live better through personalized, proactive healthcare. What You’ll Do Day-to-Day As an Ageless Provider, you’ll serve as a trusted clinician for patients pursuing lasting improvements in their health and vitality. You’ll lead patient evaluations, manage treatment plans, and oversee the delivery of safe, evidence-based therapies that produce measurable results. Daily responsibilities include: Conducting new patient consultations, reviewing medical histories, and performing physical assessments. Ordering, reviewing, and interpreting lab work and diagnostic tests to inform individualized treatment plans. Prescribing, monitoring, and adjusting testosterone replacement therapy (TRT) and related medications. Overseeing the administration of weight management treatments , including GLP-1 medications , and monitoring patient progress. Providing clinical oversight for nursing staff performing blood draws, IV therapy, and intramuscular/subcutaneous injections. Reviewing and signing off on patient charts, treatment documentation, and lab results in the EMR. Ensuring compliance with all state and federal medical regulations, safety standards, and internal protocols. Educating patients about hormone optimization, nutrition, and lifestyle modifications to enhance results. Collaborating closely with the medical director and clinical leadership to maintain consistent, high-quality care across the clinic. Our Ideal Candidate You’re a confident, relationship-driven clinician who thrives in a patient-centered environment. You value the science behind wellness medicine and are passionate about helping patients feel their best through proactive, ongoing care. You’re a great fit if you are: Energetic, positive, and self-motivated. Passionate about men’s health, hormone optimization, and preventive medicine . Skilled at interpreting labs, writing orders, and managing treatment protocols. A strong communicator who enjoys building long-term patient relationships. Excited to grow as a subject matter expert in hormone and wellness medicine . Experienced in a clinical or outpatient setting with a focus on continuity of care. Requirements Active PA-C or NP license (required) Minimum 1 year of clinical experience (preferred; hormone, primary care, or weight management experience a plus) Proficiency in ordering labs, interpreting results, and documenting in EMR systems Strong attention to detail and commitment to safe, compliant patient care Why You’ll Love Working Here At Ageless Men’s Health , you’ll find purpose, balance, and professional growth in a supportive, patient-focused environment. We offer: Monday–Friday schedule ( no nights, weekends, or call ) Positive, team-oriented clinic culture ( wellness-focused — no acute or sick patients ) Opportunities for growth into full-time roles that include comprehensive benefits package Join the Ageless Team Be part of a growing national organization that’s redefining men’s healthcare through connection, compassion, and innovation. Visit A geless Men's Health to learn more about our mission and services. #INDCLIN Keywords: Physician Assistant, Nurse Practitioner, Men’s Health Provider, Testosterone Replacement Therapy (TRT), Hormone Optimization, GLP-1 Weight Loss, Medical Weight Management, IV Therapy, Outpatient Clinic, Wellness Medicine, Preventive Care, Patient Consultations, Chart Review, No Nights or Weekends, Full-Time Provider Job.
RN Home Health Full-time
PIH Health

Registered Nurse (RN) Home Health - LA/Orange County - Full time, 8am - 5pm

apartment PIH Health location_onWhittier, CA
The RN staff nurse under the direction of and in accordance with the physician's orders administers skilled nursing care to patients at home. 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 Able to establish effective, timely working relations with patients, families, staff and physicians. Basic computer knowledge and abilities. Knowledge and ability to apply the nursing process in order to develop an individualized patient plan of care. Must have demonstrable skills in the establishment of peripheral intravenous lines and administration of intravenous therapies. Required Experience Must have a current California Registered Nurse ( BSN preferred) license renewable every two (2) years in good standing. Must have 1 year of experience as a professional nurse. Able to demonstrate clinical nursing expertise in intravenous therapies. Home Health experience preferred. Current CPR card. Current California driver's license and valid auto insurance. Address 15050 Imperial Highway Salary 50.50-84.25 Shift Days Zip Code 90602
RN Home Health Full-time
PIH Health

Registered Nurse (RN) Home Health - LA/Orange County - Full time, 0.8 FTE, 8am - 5pm

apartment PIH Health location_onWhittier, CA
The Home Health Registered Nurse performs a comprehensive patient assessment and develops an individualized patient plan of care with collaboration of an interdisciplinary team and physician approval. Under the direction of and in accordance with the physician's orders administers skilled nursing care to patients in their place of residence. Functions as a case manager and collaborates with the interdisciplinary team to meet patient outcomes and goals. As a leader of the healthcare team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance consistent with the PIH Health vision of Patients First. 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 Establish positive and professional relationships with patients, families, staff, and physicians. Demonstrate quality nursing clinical practice while meeting time-sensitive deadlines. Knowledge and ability to apply the nursing process while developing an individualized patient plan of care. Able to demonstrate clinical nursing expertise in the establishment of peripheral intravenous lines and administration of intravenous therapies. Computer skills and ability to navigate an electronic health record. Required Experience Current California license as a Registered Nurse in good standing. A minimum of one year experience as a professional nurse, preferably in an acute care facility. BSN preferred. Current CPR card. Current California driver's license and valid auto insurance. Home Health experience preferred. Address 12401 Washington Blvd. Salary 50.50-84.25 Shift Days Zip Code 90602
LVN Full-time
AltaMed

Licensed Vocational Nurse, PACE

apartment AltaMed location_onNorwalk, CA
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 LVN provides direct patient care under the direction of a Registered Nurse or Physician. The LVN tasks include, but are not limited to, vital signs, data gathering, medication administration, and rendering patient care/treatments. Minimum Requirements Graduation from an accredited LVN school. Current LVN license issued by the State of California, Vocational Nursing and Psychiatric Technicians. A minimum of 1 year of experience as an LVN is preferred . A minimum of 1 year of experience working with a frail or elderly population is preferred. Experience and knowledge regarding the physical, mental, and social needs of geriatric patients are preferred. A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines. Bilingual Spanish, Mandarin, and Cantonese highly preferred. LVN FLOAT POSITION: Current and valid driver's license and active insurance verification Compensation Pay for this job starts at $31.93 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.
RN Manager/Supervisor Full-time
AltaMed

Registered Nurse Manager, Health Services

apartment AltaMed location_onOrange, CA
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 RN Manager is responsible for the administrative and business oversight of nursing patient care services at the assigned clinic or the Patient Service Center. The Manager works collaboratively with the Site Medical Director, Clinic Director, and Administrative leadership team to achieve clinic quality, patient satisfaction, and financial goals. The Manager manages operations and services that add value and are integrated with nursing standards of practice, service priorities, and performance/outcome measures, as well as with strategic, business, and organizational goals/objectives. The Manager is responsible for the planning, development, implementation, evaluation, and improvement of clinical care services/programs, which include patient experience, patient safety, HEDIS, and value-based care quality measures, budgets, etc. The Manager is also developing and implementing quality, cost-effective, efficient, standardized patient care practices, processes, systems, and protocols, and ensures all back-office staff are up to date on clinic objectives through maintaining Quality boards, presenting progress at staff meetings, etc. The Manager serves as team leader and provides mentorship and support for nursing and clinical support staff at the assigned location, and is responsible for staff development. Minimum Requirements Bachelor’s degree in Nursing required, in lieu of a degree, 4 or more years of leadership experience. Master’s degree in health services, business administration, or management preferred. A current, valid license as a registered nurse through the California Board of Registered Nursing is required. Minimum of 3 years’ experience preferred in an outpatient or inpatient setting; ambulatory care setting preferred. Minimum of 2 years of experience in a leadership role. Experience with audits and healthcare inspections preferred. Bilingual English/Spanish/Cantonese preferred. Prior experience with an Electronic Health/Medical (EHR/EMR) system is required. 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 $119,974.40 annually 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.
LVN Full-time
AltaMed

13002-TBH-010 Licensed Vocational Nurse, PACE

apartment AltaMed location_onLos Angeles, CA
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 LVN provides direct patient care under the direction of a Registered Nurse or Physician. The LVN tasks include, but are not limited to, vital signs, data gathering, medication administration, and rendering patient care/treatments. Minimum Requirements Graduation from an accredited LVN school. Current LVN license issued by the State of California, Vocational Nursing and Psychiatric Technicians. A minimum of 1 year of experience as an LVN is preferred . A minimum of 1 year of experience working with a frail or elderly population is preferred. Experience and knowledge regarding the physical, mental, and social needs of geriatric patients are preferred. A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines. Bilingual Spanish, Mandarin, and Cantonese highly preferred. LVN FLOAT POSITION: Current and valid driver's license and active insurance verification Compensation Pay for this job starts at $31.93 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.
LVN Full-time
AltaMed

Licensed Vocational Nurse, PACE

apartment AltaMed location_onPomona, CA
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 LVN provides direct patient care under the direction of a Registered Nurse or Physician. The LVN tasks include, but are not limited to, vital signs, data gathering, medication administration, and rendering patient care/treatments. Minimum Requirements Graduation from an accredited LVN school. Current LVN license issued by the State of California, Vocational Nursing and Psychiatric Technicians. A minimum of 1 year of experience as an LVN is preferred . A minimum of 1 year of experience working with a frail or elderly population is preferred. Experience and knowledge regarding the physical, mental, and social needs of geriatric patients are preferred. A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines. Bilingual Spanish, Mandarin, and Cantonese highly preferred. LVN FLOAT POSITION: Current and valid driver's license and active insurance verification Compensation Pay for this job starts at $31.93 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.
RN Full-time
Planned Parenthood of Los Angeles

Registered Nurse Float - Pomona, CA

apartment Planned Parenthood of Los Angeles location_onPomona, CA
Planned Parenthood Los Angeles is seeking an experienced and caring Registered Nurse Float with excellent clinical, communication, and customer service skills to work full-time at our health centers in our San Gabriel Valley region and cross-regionally as needed within LA County while providing care for patients under established medical protocols. Over one hundred years ago, Planned Parenthood was founded on the idea that everyone should have the information and care they need to live strong, healthy lives and fulfill their dreams. Founded 57+ years ago, Planned Parenthood Los Angeles is one of the largest providers of reproductive health care services in Los Angeles County. The Planned Parenthood Los Angeles (PPLA) team works together to provide high-quality, affordable reproductive health care to women, men, and young people across Los Angeles County. At PPLA, you will discover a culture of like-minded individuals who are eager to make positive contributions to their community and to the Planned Parenthood mission. \n Our Ideal Candidate will have the following qualifications: A valid and current California Registered Nurse license required Current American Heart Association BLS and ACLS certification required Willingness to work flexible hours including evenings and Saturdays (at least 2 Saturdays per month ) Ability and willingness to work out of our health centers in Mid-Los Angeles and West LA (Downtown LA, South LA, West Hollywood) Reliable and flexible means of transportation is required Experience in Acute Care/Ambulatory surgery and/or PACU preferred Sedation experience preferred, but will provide training Ability to physically assist a patient in distress About the position: Abortion patients are cared for at each of our health centers, and in part through the administrative, support, and other non-clinical services provided at all PPLA locations, and by all PPLA employees. Supporting these critical services is an essential job duty, and a fundamental responsibility of all employees and contractors. Ensure adequate supply of 02, back up supply, operation of 02 tank, cannulas and tubing. Test suction machine, ensuring proper functioning and presence of necessary equipment including: tubing, tracheal aspiration cannulas and nasal aspiration cannulas. Test cardiac monitors and defibulators, ensuring and recording proper functioning. Ensure the following minimum equipment is present in recovery room: 2 IV stands, 2 blood pressure cuffs, 2 stethoscopes, Ambubag, crash cart, laundry hamper, an adequate supply of emesis basins, blankets, peri-pads, tidy towels, gloves and germicidal detergent. Perform venipuncture/phlebotomy and injections per Clinician or Physician order. Initiate, monitor and discharge IV per Clinician and/or Physician order. Perform Rh testing and interpret results. Perform pregnancy testing. Receive patient from OR, including via wheelchair or gurney and transfer to chair appropriately. Upon patient admission to the recovery room, immediately check and record vital signs, skin color, skin temperature and general condition of patient. Assess patient prior to discharge from the recovery room and document all findings. Consult provider or Physician when necessary. Assess surgical site of vasectomy patients upon admission to and discharge from the recovery room. Assess vaginal bleeding of abortion patients per PPLA Medical Standards & Guidelines (MS&G). Assess uterine tone of advanced gestation abortion patients per protocol. Administer Microgram or Rhogam to abortion patients as ordered by the Physician and/or Clinician. Administer medication as ordered by the Physician and/or Clinician. Employ appropriate aseptic technique when handling contaminated articles or surfaces. Alert Clinician and/or Physician immediately of medical emergencies. Record and sign all assessments, observations, actions and times within manual documentation system or in EMR. Follow Infection Control procedures for equipment and environmental cleaning during clinic session and upon conclusion of session. Ensure crash cart is appropriately stocked at all times. Check and complete log daily, monthly and/or as necessary. Provide direction and supervision of other Recovery Room personnel. Discharge patients at the end of their visit. Provide patient education on medication or surgical abortion, medication counseling, contraceptive counseling, and/or pertinent to diagnosis and treatment plan. Perform Quality Management audits, if requested. Adhere to Quality Management policies and procedures. Notify the Quality Director and appropriate Charge Clinician if deficiencies are found. Adhere to Safety/Risk Management policies and procedures. Notify the Center Manager if deficiencies are found. Maintain and be cognizant of HIPPA and all privacy policies regarding our patients. Additional assignments based on training and competency: Provide Hormonal Contraceptive Dispensing Services as outlined in the RN Hormonal Contraceptive Standardized Procedure competency Provide MAB support to clinicians Train and orient newly hired licensed staff Facilitate Medical Assistant IM/Venipuncture training Generous salary and benefits package includes: Medical, dental, and vision coverage options for you and eligible dependents Free basic life/AD&D policy with additional voluntary coverage options Short Term Disability, Critical Illness and Accident policies 403(b) Retirement plan with up to 3% employer match Medical and Dependent Flexible Spending Account plans Public Transportation and Commuter Pre-Tax Reimbursements Generous vacation, sick, and holiday benefits Hiring range: $55 - 60 per hour (Non-Exempt) \n Compensation Philosophy and Position Hiring Range: At Planned Parenthood Los Angeles we continuously work towards our value of "we respect and honor all people", which also relates to our compensation philosophy. PPLA recognizes that decisions about pay, and benefits have significant impact on staff, so we are committed to ensuring all positions are rooted in a description that identifies competencies, duties, responsibilities, and qualifications, and that they are compensated equitably which considers both internal organizational equity and market compensation data for similar roles. Equal Employment Opportunity will be afforded to all applicants and other covered persons without regard to protected characteristics, including their perceived protected characteristic. Protected categories include: race (including traits historically associated with race, including but not limited to, hair texture and protective hair styles such as, braids, locs, and twists as examples but not exhaustive list), color, religion or religious creed (including religious belief, observation, practice, dress, and grooming practices), national origin, ancestry, physical or mental disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding/chestfeeding, or related medical conditions), reproductive health decision-making, gender, gender identity, gender expression, age (40 years and over), sexual orientation, veteran and/or military status (including past, current or prospective service in the uniformed service), and any other characteristic protected under applicable federal, state or local law. PPLA will consider for employment qualified applicants with criminal histories in accordance with the requirements of Los Angeles Fair Chance Initiative for Hiring.
RN Full-time
Planned Parenthood of Los Angeles

Registered Nurse Float - Long Beach, CA

apartment Planned Parenthood of Los Angeles location_onLong Beach, CA
Planned Parenthood Los Angeles is seeking an experienced and caring Registered Nurse Float with excellent clinical, communication, and customer service skills to work full-time at our health centers in our South LA region and cross-regionally as needed within LA County while providing care for patients under established medical protocols. Over one hundred years ago, Planned Parenthood was founded on the idea that everyone should have the information and care they need to live strong, healthy lives and fulfill their dreams. Founded 57+ years ago, Planned Parenthood Los Angeles is one of the largest providers of reproductive health care services in Los Angeles County. The Planned Parenthood Los Angeles (PPLA) team works together to provide high-quality, affordable reproductive health care to women, men, and young people across Los Angeles County. At PPLA, you will discover a culture of like-minded individuals who are eager to make positive contributions to their community and to the Planned Parenthood mission. \n Our Ideal Candidate will have the following qualifications: A valid and current California Registered Nurse license required Current American Heart Association BLS and ACLS certification required Willingness to work flexible hours including evenings and Saturdays (at least 2 Saturdays per month ) Ability and willingness to work out of our health centers in Mid-Los Angeles and West LA (Downtown LA, South LA, West Hollywood) Reliable and flexible means of transportation is required Experience in Acute Care/Ambulatory surgery and/or PACU preferred Sedation experience preferred, but will provide training Ability to physically assist a patient in distress About the position: Abortion patients are cared for at each of our health centers, and in part through the administrative, support, and other non-clinical services provided at all PPLA locations, and by all PPLA employees. Supporting these critical services is an essential job duty, and a fundamental responsibility of all employees and contractors. Ensure adequate supply of 02, back up supply, operation of 02 tank, cannulas and tubing. Test suction machine, ensuring proper functioning and presence of necessary equipment including: tubing, tracheal aspiration cannulas and nasal aspiration cannulas. Test cardiac monitors and defibulators, ensuring and recording proper functioning. Ensure the following minimum equipment is present in recovery room: 2 IV stands, 2 blood pressure cuffs, 2 stethoscopes, Ambubag, crash cart, laundry hamper, an adequate supply of emesis basins, blankets, peri-pads, tidy towels, gloves and germicidal detergent. Perform venipuncture/phlebotomy and injections per Clinician or Physician order. Initiate, monitor and discharge IV per Clinician and/or Physician order. Perform Rh testing and interpret results. Perform pregnancy testing. Receive patient from OR, including via wheelchair or gurney and transfer to chair appropriately. Upon patient admission to the recovery room, immediately check and record vital signs, skin color, skin temperature and general condition of patient. Assess patient prior to discharge from the recovery room and document all findings. Consult provider or Physician when necessary. Assess surgical site of vasectomy patients upon admission to and discharge from the recovery room. Assess vaginal bleeding of abortion patients per PPLA Medical Standards & Guidelines (MS&G). Assess uterine tone of advanced gestation abortion patients per protocol. Administer Microgram or Rhogam to abortion patients as ordered by the Physician and/or Clinician. Administer medication as ordered by the Physician and/or Clinician. Employ appropriate aseptic technique when handling contaminated articles or surfaces. Alert Clinician and/or Physician immediately of medical emergencies. Record and sign all assessments, observations, actions and times within manual documentation system or in EMR. Follow Infection Control procedures for equipment and environmental cleaning during clinic session and upon conclusion of session. Ensure crash cart is appropriately stocked at all times. Check and complete log daily, monthly and/or as necessary. Provide direction and supervision of other Recovery Room personnel. Discharge patients at the end of their visit. Provide patient education on medication or surgical abortion, medication counseling, contraceptive counseling, and/or pertinent to diagnosis and treatment plan. Perform Quality Management audits, if requested. Adhere to Quality Management policies and procedures. Notify the Quality Director and appropriate Charge Clinician if deficiencies are found. Adhere to Safety/Risk Management policies and procedures. Notify the Center Manager if deficiencies are found. Maintain and be cognizant of HIPPA and all privacy policies regarding our patients. Additional assignments based on training and competency: Provide Hormonal Contraceptive Dispensing Services as outlined in the RN Hormonal Contraceptive Standardized Procedure competency Provide MAB support to clinicians Train and orient newly hired licensed staff Facilitate Medical Assistant IM/Venipuncture training Generous salary and benefits package includes: Medical, dental, and vision coverage options for you and eligible dependents Free basic life/AD&D policy with additional voluntary coverage options Short Term Disability, Critical Illness and Accident policies 403(b) Retirement plan with up to 3% employer match Medical and Dependent Flexible Spending Account plans Public Transportation and Commuter Pre-Tax Reimbursements Generous vacation, sick, and holiday benefits Hiring range: $55 - 60 per hour (Non-Exempt) \n Compensation Philosophy and Position Hiring Range: At Planned Parenthood Los Angeles we continuously work towards our value of "we respect and honor all people", which also relates to our compensation philosophy. PPLA recognizes that decisions about pay, and benefits have significant impact on staff, so we are committed to ensuring all positions are rooted in a description that identifies competencies, duties, responsibilities, and qualifications, and that they are compensated equitably which considers both internal organizational equity and market compensation data for similar roles. Equal Employment Opportunity will be afforded to all applicants and other covered persons without regard to protected characteristics, including their perceived protected characteristic. Protected categories include: race (including traits historically associated with race, including but not limited to, hair texture and protective hair styles such as, braids, locs, and twists as examples but not exhaustive list), color, religion or religious creed (including religious belief, observation, practice, dress, and grooming practices), national origin, ancestry, physical or mental disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding/chestfeeding, or related medical conditions), reproductive health decision-making, gender, gender identity, gender expression, age (40 years and over), sexual orientation, veteran and/or military status (including past, current or prospective service in the uniformed service), and any other characteristic protected under applicable federal, state or local law. PPLA will consider for employment qualified applicants with criminal histories in accordance with the requirements of Los Angeles Fair Chance Initiative for Hiring.
RN Utilization Review Full-time
Molina Healthcare

Medical Review Nurse (RN)

apartment Molina Healthcare location_onLong Beach, CA
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.