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
