Remote Utilization Review RN - Part-Time Day Shifts

Providence; Irvine (CA); On-site; USD 79,000 - 123,000; Part time

Benefits offered by this job

Remote work option

Job summary

Providence California Regional Services is seeking a part-time Utilization Review RN for a REMOTE daytime position. You will perform prospective, retrospective, and concurrent reviews, and review medical records daily to support payers and patient care.

The ideal candidate holds an Associate’s Degree in Nursing, California RN license, and at least two years of remote UR or acute hospital case management experience, with InterQual experience preferred.

Qualifications

• Associate's Degree in Nursing required.
• California RN license upon hire.
• Minimum 2 years in remote UR or acute hospital case management.

Responsibilities

• Provide prospective, retrospective, and concurrent utilization reviews.
• Review medical records daily for all payers as required by health plans.
• Demonstrate negotiation, communication, and decision-making in a fast-paced environment.

Skills

Utilization review

Remote UR experience

Clinical review

Education

Associate's Degree in Nursing

California RN license

Tools

InterQual guidelines

Job description

Providence California Regional Services is seeking a part-time Utilization Review RN for a REMOTE daytime position. You will perform prospective, retrospective, and concurrent reviews, and review medical records daily to support payers and patient care.

The ideal candidate holds an Associate’s Degree in Nursing, California RN license, and at least two years of remote UR or acute hospital case management experience, with InterQual experience preferred.