California Licensed Utilization Review RN
Job Summary
Providing critical utilization reviews, the part-time California Licensed Utilization Review RN will conduct prospective, retrospective, and concurrent reviews for Southern California ministries while managing a diverse workload in a fast-paced environment.
Key responsibilities
- Conduct clinical reviews and assess medical records daily during patient admissions for all payers
- Ensure compliance with utilization management standards and health plan requirements
- Utilize strong negotiation and decision-making skills to manage patient status determinations effectively
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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