California Licensed Nurse RN

Job Summary

A company is looking for a Nurse RN 3 to review medical necessity for various levels of care.

Key Responsibilities

• Evaluate medical necessity across different care levels using clinical expertise and established guidelines
• Make approval decisions or escalate cases to the in-house physician when further review is required
• Ensure timely completion of decision-making processes in compliance with regulatory requirements
• Collaborate effectively with case managers and medical staff at facilities

Required Qualifications

• Current valid CA RN license required; BSN is preferred
• Demonstrated hands-on clinical experience
• Proficient computer skills with the ability to navigate essential software and EMR systems
• Proven capacity to work remotely and manage tasks independently