Utilization review nurse Jobs in Murrieta, CA

Responsibilities

Join the Southwest Healthcare Team!

About Us :

Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care / outpatient locations here to serve the Southern California community. With over 6,000 passionate providers and healthcare employees, our shared goal is to provide convenient access to a wide range of healthcare services in a way that benefits you, your family, and the entire community.

Southwest Healthcare is comprised of five acute care hospitals and several non-hospital access points, including : Corona Regional Medical Center, Palmdale Regional Medical Center, Southwest Healthcare Rancho Springs Hospital, Southwest Healthcare Inland Valley Hospital and Temecula Valley Hospital, Temecula Valley Day Surgery, A+ Urgent Care Centers, and Riverside Medical Clinics. For more information, please visit our website at www.swhealthcaresystem.com .

Job Summary :

The Southwest Healthcare Regional office in Temecula, CA is seeking a Full-Time RN Central Utilization Review Nurse who will be responsible for carrying out utilization management functions by planning, coordinating, and managing patient needs during hospitalization and throughout the continuum of care. Duties include but not limited to :

• Conducts admission and continued stay reviews per guidelines to ensure medical necessity of level of care and hospitalization for multiple entities.
• Reviews medical record for presence of accurate placement orders reconciles variances with patient providers.
• Works collaboratively with attending providers, specialty providers, and physician advisors to ensure application of evidence-based guidelines for determining appropriate status.
• Collaborates with Patient Access team to ensure correct payer source for hospitalization and communication.
• Ensures compliance of utilization review practices as required by payers, external regulatory agencies, and organization.
• Hybrid schedule may be considered after 90 days of employment.
• Must be available to work weekends and holidays.

Qualifications

Experience / Training / Experience :

Certifications / Licenses :

Other Skills and Abilities :

Benefit Highlights :

Southwest Healthcare is owned and operated by subsidiaries of Universal Health Services, Inc. (UHS) , a King of Prussia, PA-based company, that is one of the largest healthcare management companies in the nation.

UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or e-mails. All resumes submitted by search firms to any employee at UHS; via e-mail, the Internet or in any other form and / or method without a valid written search agreement in place for the above-listed position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.

EEO Statement :

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Notice :

At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at : https : / / uhs.alertline.com or 1-800-852-3449.