RN Utilization Review - Full-time - REMOTE
Job Description reputed company prospective, retrospective, and reputed company utilization reviews for our Southern CA 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. Required Qualifications:
- Associate's Degree Nursing.
- Upon hire: California Registered Nurse License
- 2 years Experience working in a remote UR environment or working as an acute hospital case manager.
Preferred Qualifications:
- Bachelor's Degree Nursing.
- Master's Degree Nursing.
- Experience working with Interqual guidelines.
- Experience in a multi-hospital and/or integrated reputed company system.
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. 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. Apply tot his job Apply To this Job