California Licensed Utilization Review RN
Job Summary
To support utilization management efforts, the full-time California Licensed Utilization Review RN will conduct prospective, retrospective, and concurrent reviews of medical records for Southern California ministries, working remotely during day shifts.
Key responsibilities
- Conduct clinical reviews and assess medical necessity for all payers during patient admissions
- Manage a diverse workload in a fast-paced regulatory environment
- Utilize negotiation and decision-making skills to determine patient status effectively
Required qualifications
- Associate's Degree in Nursing
- California Registered Nurse License upon hire
- 2 years of experience in a remote utilization review environment or as an acute hospital case manager
Complete Job Description
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