Night RN II: Utilization & Admissions Liaison

Working Nurse; Los Angeles (CA); On-site; USD 89,000 - 142,000; Full time

Job summary

The Utilization Management Admissions Liaison RN II (Nights) at Working Nurse in Los Angeles, CA, reviews admission requests and transfers, determines medical necessity, and coordinates with inpatient teams for timely decisions. This role emphasizes discharge planning and coordination across facilities, ensuring efficient patient care pathways.

Requires an Associate's in Nursing and a Bachelor’s in Nursing, with a minimum of seven years in an acute hospital setting and knowledge of UM/Case

Qualifications

• Minimum of 7 years of clinical experience in an acute hospital setting.
• Understanding of Utilization Management/Case Management practices including placement criteria (MCG, InterQual), concurrent review, and discharge planning.

Responsibilities

• Receive/review admission requests and HLOC transfer requests from inpatient facilities within regular timelines.
• Review clinical data in real-time and post admission to issue determinations of medical necessity.
• Generate approval, modification, and denial communications for inpatient admission requests.
• Assist with discharge planning and coordinate transfers and alternate levels of care as needed.

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Job description

The Utilization Management Admissions Liaison RN II (Nights) at Working Nurse in Los Angeles, CA, reviews admission requests and transfers, determines medical necessity, and coordinates with inpatient teams for timely decisions. This role emphasizes discharge planning and coordination across facilities, ensuring efficient patient care pathways.

Requires an Associate's in Nursing and a Bachelor’s in Nursing, with a minimum of seven years in an acute hospital setting and knowledge of UM/Case