Remote RN Utilization Review Specialist

CommonSpirit Health; United States; Remote; USD 95,000 - 125,000; Full time

Job summary

A healthcare facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The role involves collaboration with various stakeholders, including physicians and Care Coordination staff, to support patient admissions. Candidates must have a valid California RN license and at least two years of clinical experience or a Master's degree in a related field. The position offers remote work with emphasis on critical thinking and problem-solving skills.

Qualifications

• Minimum two years of acute hospital clinical experience or equivalent education.
• Must have a California RN license.
• Must pass annual inter-rater reliability test.

Responsibilities

• Review medical records for appropriate admission status.
• Collaborate with physicians and Care Coordination staff.
• Establish and verify the correct payer source for patient stays.

Skills

Critical thinking

Problem-solving

Professional communication

Time management

Education

California RN license

Master's degree in Case Management or Nursing

Bachelor's Degree in Nursing (BSN)

Job description

A healthcare facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The role involves collaboration with various stakeholders, including physicians and Care Coordination staff, to support patient admissions. Candidates must have a valid California RN license and at least two years of clinical experience or a Master's degree in a related field. The position offers remote work with emphasis on critical thinking and problem-solving skills.