California Licensed Utilization Review Nurse

Job Summary

A company is looking for a Temp Utilization Review Nurse.

Key Responsibilities

• Review medical records to assess the medical necessity of treatment requests based on evidence-based guidelines
• Identify medical diagnoses and treatment plans, validating them against established algorithms of care
• Communicate UR determinations to relevant parties within the prescribed time frame and summarize findings for the Physician Advisor

Required Qualifications

• Minimum of 3 years clinical experience
• Experience in California Worker's Compensation and Managed Care/Utilization Review preferred
• Familiarity with California Worker's Compensation regulations and medical terminology
• Completion of IEA CA10 required within one year of employment
• Ability to direct ancillary non-licensed personnel as needed