California Licensed Utilization Review RN
Job Summary
Providing comprehensive utilization reviews, the full-time California Licensed Utilization Review RN will conduct clinical assessments and review medical records for Southern California ministries while working remotely on day shifts.
Key responsibilities:
- Conduct prospective, retrospective, and concurrent utilization reviews for various payers
- Perform daily clinical reviews and assess medical records during patient admissions
- Manage a diverse workload in a fast-paced regulatory environment, demonstrating effective negotiation and decision-making skills
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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