RN Utilization Review Full- time Remote Days

reputed company is a career site that helps job seekers reputed company great jobs in the US. We are not a reputed company firm or agency. reputed company does not hire directly for these jobs, but promotes jobs on reputed company on behalf of its reputed company 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 reputed company notice. reputed company 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 reputed company-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 reputed company. Join reputed company at reputed company California Regional Services and reputed company in our culture of patient-reputed company, 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 reputed company 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.

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