Remote Utilization Review RN (Part-Time, Day)
Providence
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Job summary
Providence California Regional Services seeks a part-time Utilization Review RN for a remote Day shift in Southern California. The role conducts prospective, retrospective, and concurrent utilization reviews, reviewing medical records daily for all payers as required by health plans.
Requires Associate's Degree in Nursing and California RN license; 2 years of remote UR or hospital case management experience.
Qualifications
- Associate's Degree in Nursing required.
- California Registered Nurse License required on hire.
- Minimum 2 years of experience in remote utilization review or hospital case management.
Responsibilities
- Provide prospective, retrospective, and concurrent utilization reviews for Southern California ministries.
- Review medical records daily during admission for all payers as required by health plans.
- Manage a diverse workload in a fast-paced regulatory environment with strong negotiation and communication skills.
Skills
Education
Job description
Providence California Regional Services seeks a part-time Utilization Review RN for a remote Day shift in Southern California. The role conducts prospective, retrospective, and concurrent utilization reviews, reviewing medical records daily for all payers as required by health plans.
Requires Associate's Degree in Nursing and California RN license; 2 years of remote UR or hospital case management experience.
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