California Licensed Utilization Management Nurse

Job Summary

A company is looking for a Utilization Management Nurse - Remote.

Key Responsibilities

• Performs all functions of a Utilization Management Nurse
• Reviews patient referrals and ensures compliance with utilization management policies and regulatory timeframes
• Communicates authorization or denial of services to appropriate parties and maintains accurate documentation of care rendered

Required Qualifications

• Graduation from an accredited school of Nursing
• Current California RN license
• Ability to work Pacific Standard Time (PST)
• Experience with preparing referral requests for medical necessity
• Understanding of HIPAA standards regarding patient information