California Licensed Utilization Review Author

Job Summary

A company is looking for a Utilization Review Author (Weekend).

Key Responsibilities

• Perform initial admission and continued stay reviews utilizing InterQual or Milliman
• Abstract data from medical records to ensure accurate clinical data
• Adhere to quality, timeliness, and productivity outputs for nursing utilization review

Required Qualifications

• Active Registered Nurse (RN) license in the state of residence
• Eligibility to obtain a California RN license
• Experience in a clinical inpatient environment
• Hospital-based utilization or case management experience
• Proficiency in basic computer skills