Remote Utilization Review Registered Nurse in Sacramento

Location: California

Compensation: To Be Discussed

Staff Reviewed: Mon, Nov 22, 2021

This job expires in: 22 days

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Staffing Agency

Career Level: Experienced

Education Level: Bachelors

Job Summary

A healthcare staffing and recruiting firm has an open position for a Remote Utilization Review Registered Nurse in Sacramento.

Core Responsibilities of this position include:

  • Providing utilization management and utilization review
  • Determining medical appropriateness of inpatient and outpatient services
  • Obtaining the information necessary to assess a member's clinical condition

Position Requirements Include:

  • Current, valid, and unrestricted state Registered Nurse (R.N.) license
  • 2 years acute care clinical nursing experience
  • Knowledge of guidelines for Medicaid/Medicare and related state programs
  • 1 year of recent experience in Discharge Planning or Utilization Review or Utilization Management
  • 1 or more years of experience using InterQual criteria for medical necessity
  • Computer skills to include Microsoft Word, Excel, database use, and basic data entry

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