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California Licensed Utilization Management RN

Company: VirtualVocations
Location: Moreno Valley
Posted on: October 30, 2024

Job Description:

A company is looking for an RN, Utilization Management - Remote.



Key Responsibilities

Perform all functions of a UM nurse reviewer and compose compliant denial letters
Ensure accurate clinical decision-making and documentation for adverse determinations
Collaborate with UM compliance for quality improvement and escalate non-compliance cases



Required Qualifications

Graduation from an accredited school of nursing
Active, unrestricted Registered Nurse license through the State of California
3+ years of care management, utilization review, or discharge planning experience
Bachelor of Science in Nursing (BSN) preferred
HMO experience preferred

Keywords: VirtualVocations, Lake Forest , California Licensed Utilization Management RN, Healthcare , Moreno Valley, California

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