Utilization Review RN – Per Diem

This is a fully remote position, open to applicants in California.

📋 Description

• Conduct utilization reviews—prospective, retrospective, and concurrent—for ministries in Southern California.

• Perform daily clinical reviews and assess medical records during admissions for all payers, as mandated by health plans.

• Effectively manage a varied workload in a dynamic, fast-paced regulatory environment.

• Exhibit exceptional skills in negotiation, communication, problem-solving, and decision-making.

⛳️ Requirements

• An Associate's Degree in Nursing.

• California Registered Nurse License required upon hiring.

• Minimum of 2 years' experience in a remote Utilization Review setting or as a case manager in an acute hospital.

• Bachelor's Degree in Nursing is preferred.

• Master's Degree in Nursing is preferred.

• Familiarity with Interqual guidelines is preferred.

• Experience in a multi-hospital and/or integrated healthcare system is preferred.

🏝️ Benefits

• A comprehensive benefits package that includes a 401(k) Retirement Savings Plan with employer matching.

• Health care benefits, including medical, dental, and vision coverage.

• Life insurance.

• Disability insurance.

• Time off benefits, such as paid parental leave, vacations, holidays, and health-related issues.

• Voluntary benefits.

• Resources for well-being.