California Licensed Review Nurse

A company is looking for a Pre-Service Review Nurse RN to work remotely in the Pacific or Mountain Time Zones.

Key Responsibilities

Conduct utilization management, including Prior Authorization Review for various care facilities

Evaluate medical appropriateness of care levels based on guidelines and benefit determinations

Provide guidance and solutions for complex issues and non-standard requests

Required Qualifications

Unrestricted RN License in California and state of residence

3+ years of Clinical Nursing experience

1+ years of Utilization Review and / or Prior Authorization experience in Managed Care

Basic computer skills with MS Outlook, Word, and Excel

Ability to work Mon-Fri 8-5 PST or MST and at least 2 weekend days per month