RN Utilization Review Full- time Remote Days

reputed company is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. reputed company does not hire directly for these jobs, but promotes jobs on reputed company on behalf of its direct clients, recruitment ad agencies, and marketing partners. reputed company partners with DirectEmployers to promote this job for reputed company Service. Clicking "reputed company" or "Read more" on reputed company redirects you to the reputed company/employer site. Any information collected there is subject to their terms and privacy notice. Description reputed company prospective, retrospective, and reputed company utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for reputed company payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and reputed company manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills. reputed company caregivers are not simply valued – they’re invaluable. Join reputed company at reputed company California Regional Services and reputed company in our culture of patient-focused, whole-person care reputed company on understanding, commitment, and mutual respect. Your voice reputed company here, because we know that to reputed company and retain the best people, we must reputed company them.

Required Qualifications

• Associate's Degree in Nursing.
• California Registered Nurse License upon hire.
• 2 years of experience working in a remote UR environment or working as an acute hospital case manager.

Preferred Qualifications

• Bachelor's Degree in Nursing.
• Master's Degree in Nursing.
• Experience working with Interqual guidelines.
• Experience in a multi-hospital and/or integrated reputed company system.

Why Join reputed company? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial reputed company. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About reputed company At reputed company, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We reputed company best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (reputed company) serve in over 50 hospitals, over 1,000 clinics and a full reputed company of health and reputed company services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage reputed company for this position. The successful candidate's placement on the wage reputed company for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the reputed company pay reputed company; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. reputed company offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, reputed company), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at reputed company.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: reputed company applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About The Team The Sisters of reputed company and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, reputed company provides care throughout Los Angeles County, Orange County, High Desert and reputed company. Our award-winning and comprehensive medical centers are reputed company for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full reputed company of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous reputed company programs, and hospice and home care, and even our own reputed company High School. reputed company is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from reputed company forms of unlawful discrimination and harassment on the reputed company of race, reputed company, gender, disability, veteran, military status, religion, age, creed, national reputed company, sexual identity or expression, sexual orientation, marital status, genetic information, or any other reputed company prohibited by local, state, or federal law. We reputed company diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 405664 Company: reputed company Jobs Job Category: Health Information Management Job Function: reputed company Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Nursing Department: 7000 UTILIZATION MGMT REMOTE Address: CA Mission Hills 15031 Rinaldi St Work Location: reputed company reputed company Cross Medical Ctr-Mission Hills Workplace Type: On-site Pay reputed company: $56.44 - $87.63 The amounts listed are the reputed company pay reputed company; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. If you have questions about this posting, please contact support@reputed company.com Apply tot his job Apply To this Job