RN Jobs in East Los Angeles, CA
$88,854 - $142,166 / year
Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures timely and accurate determination and notification of referrals and reconsiderations based on the referral determination status. Generates approval, modification and denial communications, to include member and provider notification of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review. Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers. Acts as a department resource for medical service requests /referral management and processes. Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps. Follows up with caller to provide response or resolution steps. Answers all inquiries in a professional and courteous manner. Duties Promote and support team engagements, programs and activities to create and ensure a positive and productive workplace environment. Perform telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, the member and significant others to develop and implement a successful discharge plan. Process, finalize and facilitate inbound requests that are received from providers. Generate appropriate member and provider communication for all determinations within the required timelines as defined by the most current department policy. Facilitate/review requests for Higher level of care or skilled nursing/discharge planning needs. Research for appropriate facilities, specialty providers and ancillary providers to utilize for all lines of business. Identification of potential areas of improvement within the provider network. Identify and initiate referrals for appropriate members to the various L.A. Care programs/processes and external community based programs or Linked and Carve Out Services (e.g. DDS/CCS/MH). Potential quality of care/potential fraud issues are identified and documented per L.A. Care policy. High risk/high cost cases and reports are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize designated software system to document reviews and/or notes. Receive incoming calls from providers, professionally handle complex calls, research to identify timely and accurate resolution steps. Follow up with caller to provide response or resolution steps. Answer all inquiries in a professional and courteous manner. Perform other duties as assigned. Duties Continued Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 5 years of varied RN clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group or management services organization. Experience with Managed Medi-Cal, Medicare, and commercial lines of business. Skills Required: Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint. Effectively utilizes computer and appropriate software and interacts as needed with L.A. Care Information System. Knowledge of personal computer, keyboarding, and appropriate software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Prepare clear, comprehensive written and oral reports and materials. Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team Excellent time management and priority-setting skills. Maintains strict member confidentiality and complies with all HIPAA requirements. Strong verbal and written communication skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge of Department of Health Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light Additional Information May work on occasional weekends and some holidays depending on business needs. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO) 
$93,100 - $146,000 / year
Posting Date 03/09/2026 10211 Long Beach Blvd, Lynwood, California, 90262-1508, United States of America As a Healthcare Operations Manager (Facility Administrator) at DaVita, you’ll be a part of a Team that values work-life balance and where your personal and professional growth is a top priority. DaVita has an open position for a Healthcare Operations Manager (Facility Administrator) who must be an ambitious, operationally-focused and results-driven leader. You will directly impact patient care as the trusted front-line leader in an outpatient clinic setting. Health care experience is not required! What you can expect as a Healthcare Operations Manager: Patients come first. You have an opportunity to build on your relationship with your patients, while also continuously improving their health through clinical goal setting and quality improvement initiatives. Meaningful Workday - EVERY Day. You'll go home every day knowing you are making a difference in patients' lives and that you are developing your team to reach their full potential. Available when the clinic is open. Lead a Team. Develop, mentor and inspire a cross-functional clinical team (census dependent on state laws) to deliver the best for our patients, teammates and community. Financial Management. Manage complete operation and performance of the clinic: adhere to budget, forecast expenses, manage vendor relationships, order supplies, and monitor compliance. Autonomy. It's your clinic to run. You aren't alone though. You will have the support and guidance of your director, regional peers and the greater company to help you manage your facility. We foster entrepreneurs and those who seek to continuously improve. Culture & Growth. Our values are not just written in a book somewhere, but are an intentional part of everything we do. As leaders, you are able to reward others for demonstrating those shared beliefs and behaviors, and in turn, we intend to do the same for you. Partner with Regional Operations Director to identify and address employee and patient concerns to drive towards Regional goals and standards Now is your time to explore your next journey—at DaVita. What you can expect: Lead a Team that appreciates, supports and relies on each other in a positive environment. Performance-based rewards based on stellar individual and team contributions. What we'll provide: DaVita is a clinical leader! We have the highest percentage of facilities meeting or exceeding CMS's standards in the government's two key performance programs. We expect our nurses to commit to improving patient health through clinical goal-setting and quality improvement initiatives. Comprehensive benefits: DaVita offers a competitive total rewards package to connect teammates to what matters most. We offer medical, dental, vision, 401k match, paid time off, PTO cash out, paid training and more. DaVita provides the opportunities for support for you and your family with family resources, EAP counseling sessions, access to Headspace®, backup child, elder care, maternity/paternity leave, pet insurance and so much more! Requirements: Associate's degree preferred, unless required by the state; Bachelor's degree in related area strongly preferred Minimum of one year experience required in management (healthcare, business, or military) or equivalent renal experience (nurse, dietitian, social worker, LPN, etc.) at discretion of DVP and/or ROD Current license to practice as a Registered Nurse if required by state of employment Current CPR certification required (or certification must be obtained within 60 days of hire or change in position) Other qualifications and combinations of skills may be considered at discretion of ROD and/or Divisional Vice President Collaboration is a much to be successful in this role. You will be working with clinical and financial teams on a daily basis to produce results that align to business needs. Intermediate computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required. Now is your time to join Team DaVita. Take the first step and apply now. #LI-HM1 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. The Salary Range for the role is $93,100 - $146,000 per year. For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information. 
$94,000 - $158,000 / year
Sign On Bonus! Azura Vascular Care is looking to hire a Full Time ASC Charge Nurse / Director of Nursing for our vascular surgery center in Garden Grove, CA. In this role you will be clinical and administrative. You must have leadership experience as you will be overseeing the clinical staff. Quarterly Bonus Opportunities! Hours are Monday through Friday. No evenings, weekends or major holidays. Excellent Benefits: Medical, dental, vision, prescription, paid maternity & paternity leave, 401K w/ match, PTO, tuition assistance, life insurance, Long Term and Short Term disability, Flexible Spending for Healthcare, Dependent Care & Commuter Expenses PURPOSE AND SCOPE: Works with the Facility Manager, facility staff and physician to coordinate the facility operations and patient procedures to ensure provision of quality patient care on a daily basis in accordance with organization policies, procedures and training. Provides nursing support to patients and staff. Assist with staffing, staff training, equipment, physician and patient relations, cost containment, supply management, medical records, patient billing, OSHA and all company, state and federal compliance. PRINCIPAL DUTIES AND RESPONSIBILITIES: Responsible for supporting and driving Organization quality standards through meeting regulatory requirements and the practice of Continuous Quality Improvement (CQI), including use of Organization CQI tools. Accountable for outstanding quality of patient care, as defined by the organization quality goals, by working with the Vice President of Quality and other organization management to ensure that organization/ASC policies and procedures are followed. Responsible for aggressively addressing and acting on adverse events and action thresholds. Complies with all data collections and auditing activities and maintains integrity of medical records and other organization administrative and operational records. Supervises and directs facility staff in providing safe and effective vascular access procedures to patients in compliance with standards outlined in the facility policy and procedures manuals, as well as regulations set forth by the company, federal and state agencies. Assigns and delegates tasks to all direct patient care staff, including Staff RNs, Radiology Technologists, Front Desk Coordinator. Ensures adequate staffing through daily management of staff's schedule, including breaks. Assess daily patient needs and develop/distribute patient care assignments appropriately. Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures and assist as necessary. Recommends and initiates disciplinary action in conjunction with the Facility Manager. Assists Facility Manager with staff performance evaluations. Participates in selection, orientation and training of staff as assigned. Performs and sets-up in-services regarding equipment, supplies and clinical for all staff. Coordinates all aspects of patient care with the appropriate staff members, from admission through discharge. Ensures patients and patient's families are educated regarding pre and post procedure care of vascular access. Ensures patient's procedures are scheduled in a timely manner and the facility capacity is utilized efficiently. As needed, assist with patient workflow, including providing direct patient care and monitoring pre, intra and post procedure. Oversees and ensures accurate and complete documentation of patient treatments from admission to discharge. Confirms written orders, consents and lab work are completed and documented in accordance with facility policies. This includes appropriate preparation of lab requisitions, delivery to appropriate labs, reporting and forwarding of lab results to appropriate physician. Assumes primary responsibility in an emergency situation and must maintain competency with all emergency operational procedures, and initiate CPR and emergency measures as needed. Administers medications and IV conscious sedation to patients as directed per physician's orders, and in compliance with company, federal, state and local regulations. Attends and participates in Governing Body and CQI meetings with physicians, assisting with meeting agenda and gathering of data/material for meetings and reporting on assigned topics. Ensures appropriate operation of facility equipment and technology, including but not limited, patient monitors, defibrillators, medical recording devices and computers. Maintains a clean, safe and sanitary environment in the entire vascular access facility at all times through regular inspection of facility equipment and operation systems, reporting any malfunctions or maintenance issues. Ensures all blood spills are immediately addressed according to the organization Bloodborne Pathogen Control Policies. Participates in cost control initiatives. Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve supply cost goals following all guidelines established in the organization formularies. Assists in the development and revision of any applicable policies and procedures for the facility as directed to ensure continuous process improvement. Initiates, documents and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports and attend meetings as required. Manages medications, including ordering, receiving, and inventory control and checking for expired medications, including appropriate recording of controlled substances as required by law. Oversees maintenance of usage logs for all medications with appropriate documentation, as well as, records of drug disposal. Communicates with the pharmacist to assure medication accuracy, including appropriate recording of controlled substances as required by law. Ensures medical records are accurate, complete and in compliance with organization policies and procedures prior to discharge of the patient. Performs chart audits on a regular basis. Participates in all facility regulatory and accreditation surveys and action plans to address any deficiencies identified. Verifies records for all implanted devices are completed accurately, timely and maintained according to records management guidelines. Acts as the Facility Manager in the absence of the manager or at the direction of organization management. Appointed Governing Body positions, takes on primary role of certain position or oversees staff delegated to positions. Complies with HIPPA policies and standards regarding patient information and medical records. Maintain CLIA license with Facility Administrator. Other duties as assigned, within the scope of practice and state regulations. Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and 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. Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. SUPERVISION: Facility direct patient care staff (Staff RNs, LPNs, Radiology Technologist, Surgical , Front Desk Coordinator) EDUCATION: Graduate of an accredited School of Nursing (R.N.) Current appropriate state licensure and ACLS certification. ASC certification preferred EXPERIENCE AND REQUIRED SKILLS: Minimum of three years' experience preferred in an Ambulatory Surgical Center/Vascular Access Lab, or a combination of ASC, surgical, Interventional Radiology and ICU/CCU experience. Minimum of three years of Interventional Radiology, scrub experience preferred. Supervisory or management experience within a medical or vascular access environment preferred. Proficiency with the Microsoft office suite is necessary. Experience with Medical database software. Demonstrated management skills necessary to provide leadership and supervision of facility personnel and to ensure the delivery of maximum quality care to all patients. Good communication skills - verbal and written. Certified in BLS & ACLS successfully completed course certifications. The rate of pay for this position will depend on the successful candidate’s work location and qualifications, including relevant education, work experience, skills, and competencies. Annual Rate: $94000.00 - $158000.00 Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave and potential for performance-based bonuses depending on company and individual performance. Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. Fresenius Medical Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sexual orientation, gender identity, parental status, national origin, age, disability, military service, or other non-merit-based factors 
