Utilization Management Nurse Specialist RN II
L.A. Care Health PlanLos Angeles, California, United States
Posted March 10, 2026
88454 - 142166 USD
Full Time
About the Company
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.
Job Description
The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. 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.
Requirements
- 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
- Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint
- Excellent time management and priority-setting skills
- Maintains strict member confidentiality and complies with all HIPAA requirements
Benefits
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
