California Licensed Utilization Review RN
Job Summary
A company is looking for a Utilization Review Author to assist hospital clients with case reviews.
Key Responsibilities
- Perform initial admission and continued stay reviews using InterQual or Milliman to determine appropriate levels of care
- Abstract data from medical records to ensure accurate clinical information
- Adhere to quality, timeliness, and productivity standards 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
COMPLETE JOB DESCRIPTION
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