Remote Utilization Review RN – Part-Time Day Shift

Providence Health & Services; Irvine (CA); On-site; USD 79,000 - 122,000; Part time

Job summary

Providence California Regional Services is seeking a remote Utilization Review RN for a part-time daytime role. You will perform prospective, retrospective and concurrent utilization reviews for Southern California ministries and review medical records during admission for all payers.

The position requires an Associate's Degree in Nursing, California RN license, and at least two years of remote UR or hospital case management experience.

Qualifications

• Associate's Degree in Nursing required.
• California RN license required upon hire.
• 2 years of experience in remote utilization review or hospital case management.

Responsibilities

• Provide prospective, retrospective and concurrent utilization reviews for Southern CA ministries.
• Review medical records daily during admission for all payers as required by health plans.
• Demonstrate strong clinical judgment, communication, negotiation and decision-making skills in a fast-paced regulatory environment.

Skills

Clinical nursing

Utilization management

Remote UR experience

Communication

Negotiation

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Master's Degree in Nursing

Tools

Interqual guidelines

Job description

Providence California Regional Services is seeking a remote Utilization Review RN for a part-time daytime role. You will perform prospective, retrospective and concurrent utilization reviews for Southern California ministries and review medical records during admission for all payers.

The position requires an Associate's Degree in Nursing, California RN license, and at least two years of remote UR or hospital case management experience.