Per Diem Utilization Review RN II: Care Coordination

Marin General Hospital; California (MO); Hybrid; USD 91,000 - 136,000; Full time

Job summary

MarinHealth Medical Center is seeking an Utilization Review Nurse II for per diem daytime shifts in Greenbrae, CA. The role focuses on admission, concurrent, and retrospective reviews for designated health plans, applying approved criteria, assessing clinical stability, and coordinating transfer back to MarinHealth when needed.

The ideal candidate holds a BSN with 3+ years in acute care, UR and discharge planning experience, and strong communication skills.

Qualifications

• Bachelor of Science in Nursing required.
• Three (3) or more years of experience in an acute patient care setting preferred.
• Substantial experience in utilization review and/or discharge planning in an acute care setting preferred.
• Experience applying evidence-based criteria related to utilization management.

Responsibilities

• Complete admission reviews same day or within 24 hours.
• Conduct continued stay reviews and verify treatment plans.
• Escalate cases to Medical Director when appropriate and prepare appeals.
• Review RAC denials and determine if appeals are warranted.

Skills

Communication

Interpersonal skills

Problem solving

Time management

Education

Bachelor of Science in Nursing

Tools

EHR software

Microsoft Office

Job description

MarinHealth Medical Center is seeking an Utilization Review Nurse II for per diem daytime shifts in Greenbrae, CA. The role focuses on admission, concurrent, and retrospective reviews for designated health plans, applying approved criteria, assessing clinical stability, and coordinating transfer back to MarinHealth when needed.

The ideal candidate holds a BSN with 3+ years in acute care, UR and discharge planning experience, and strong communication skills.