California Licensed Utilization Management RN
Company: VirtualVocations
Location: Moreno Valley
Posted on: October 30, 2024
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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, National City , California Licensed Utilization Management RN, Healthcare , Moreno Valley, California
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