Registered Nurse - Utilization Management
Los Angeles County, California
- Eligibility
- RN
Posted Jul 15
What the listing says
Role
- Accepts
- RN
Ratio not posted. Ask in the interview.
Pay
- Against the board
- Inside the CA staff range
CA staff postings that state pay run $33/hr to $86/hr, the middle half $43/hr to $69/hr, across 1945 postings.
About this role
The Utilization Management Nurse supports the delivery of high-quality, medically necessary, cost-effective, and compliant care for myPlace Health participants. This role reviews, coordinates, and monitors participant services to ensure care decisions align with clinical needs, PACE requirements, and applicable Medicare and Medicaid guidelines. Responsibilities include conducting concurrent and retrospective utilization reviews for inpatient, outpatient, specialty care, skilled nursing facility, and ancillary services; monitoring hospitalizations and transitions of care; collaborating with the Interdisciplinary Team; and supporting compliance with CMS, DHCS, Medicare, Medicaid, and PACE requirements.
Sourced from a public job board.
Requirements
- & Experience
Benefits
- Annual employee bonus program
- Medical, Dental, Vision coverage
- Generous paid-time-off (PTO)
- 11 paid holidays per year plus 1 additional floating holiday
- 401(k) Retirement Saving Plan with employer match
- Robust employee recognition program
Show all 7 benefitsShow fewer
- Robust Wellness Program
Place
- City
- Los Angeles County, California
- State price level
- 11% above the national average
California index 110.7, where 100 is the national average.
Los Angeles County spans Pacific coastline, mountain foothills, and sprawling urban centers, offering everything from beachside communities like Santa Monica to inland suburban hubs. It's a vast, multicultural region where outdoor recreation meets entertainment culture under year-round sunshine, giving nurses plenty of lifestyle options across its many distinct cities and neighborhoods.
Cost figures from U.S. Bureau of Economic Analysis · 2024 Regional Price Parities.
How this role fits you
About the employer
myPlace Health is a Program of All-Inclusive Care for the Elderly (PACE) organization that integrates medical, social, and supportive services to help older adults remain in their homes rather than moving to institutional care settings. The organization operates day health…
Worth asking
We can’t answer these from the listing we have. Good ones to ask a recruiter or in the interview.
- Can you walk me through differentials?
- What should I expect for shifts, weekly hours, weekend, holiday, call, and rotation?
- What orientation, preceptor time, and ongoing unit support are included?
- How are patient load, floating, and staffing support handled day to day?