Pediatric Utilization Management RN

Rady Children's Hospital-San Diego; Orange (CA); In loco; USD 97.000 - 151.000; Tempo pieno

Descrizione del lavoro

CHOC is seeking a Utilization Management Registered Nurse to coordinate benefit management and promote high-quality, cost-effective pediatric care inOrange, California. The UM RN will work with the Medical Director and UM team, applying clinical judgment to ensure medical necessity and regulatory compliance.

The role requires strong communication, critical thinking, and collaboration, with a focus on accuracy, efficiency, and patient-centered outcomes in a dynamic hospital setting.

Competenze

• Minimum of two years of pediatric nursing experience.
• BSN degree required.
• California RN license required.

Mansioni

• Coordinate benefit management and review requests for medical necessity and adherence to regulatory guidelines.
• Collaborate with Medical Director and UM team to ensure appropriate care and cost effectiveness.

Conoscenze

English communication

Critical thinking

Multitasking

Organization

Under pressure

Problem solving

Attention to detail

Independent work

Team collaboration

Memory recall

Formazione

BSN

Strumenti

Cerner

MCG

EZ-Cap

Microsoft Office

Descrizione del lavoro

CHOC is seeking a Utilization Management Registered Nurse to coordinate benefit management and promote high-quality, cost-effective pediatric care inOrange, California. The UM RN will work with the Medical Director and UM team, applying clinical judgment to ensure medical necessity and regulatory compliance.

The role requires strong communication, critical thinking, and collaboration, with a focus on accuracy, efficiency, and patient-centered outcomes in a dynamic hospital setting.