RN: Central Utilization Review - Hybrid Eligible

Universal Health Services, Inc.; Temecula (CA); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical/Dental/Vision

Retirement plan

Student loan program

Tuition reimbursement

Career development

Job summary

Universal Health Services, Inc. in Temecula, CA is seeking a Full-Time RN Central Utilization Review Nurse to manage patient needs during hospitalization and the continuum of care.

Responsibilities include admission/continued stay reviews, chart reviews, collaboration with providers, payer coordination, and ensuring compliance with guidelines. Hybrid schedule may be considered after 90 days; weekend/holiday availability required.

Qualifications

• Associates degree in Nursing or Vocational Nursing diploma is required.
• Two years of clinical experience in an acute care hospital with at least one year in case management.

Responsibilities

• Conduct admission and continued stay reviews to ensure medical necessity.
• Review medical records for placement orders and reconcile variances.
• Collaborate with attending and specialty providers to apply evidence-based guidelines.
• Coordinate with Patient Access to verify payer source and communication.
• Ensure compliance with payers and regulatory agencies.
• Hybrid schedule may be considered after 90 days of employment.
• Must be available to work weekends and holidays.

Skills

Leadership

Organization

Communication

Interpersonal skills

PC skills

Education

Associate degree in Nursing

Vocational Nursing diploma

Job description

Universal Health Services, Inc. in Temecula, CA is seeking a Full-Time RN Central Utilization Review Nurse to manage patient needs during hospitalization and the continuum of care.

Responsibilities include admission/continued stay reviews, chart reviews, collaboration with providers, payer coordination, and ensuring compliance with guidelines. Hybrid schedule may be considered after 90 days; weekend/holiday availability required.