RN Utilization Review Part- time Day

Provide 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 built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to reputed company and retain the best people, we must reputed company them.

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 healthcare 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.