California Licensed RN Utilization Review
Job Summary
California Licensed RN Utilization Review, this per diem remote position involves conducting prospective, retrospective, and concurrent utilization reviews, requiring a strong clinical background and knowledge in Utilization Management.
Key Responsibilities
- Conduct clinical reviews and daily medical record evaluations during patient admissions for all payers
- Perform utilization reviews for Southern California ministries
- Determine medical necessity and patient status based on established guidelines
Required Qualifications
- Associate's Degree in Nursing
- California Registered Nurse License upon hire
- Two years of experience in a remote Utilization Review environment or as an acute hospital case manager
COMPLETE JOB DESCRIPTION
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