Registered Nurse (RN), Utilization Management, Full Time, Days Alternating Weekends

The Utilization Management (UM) RN performs utilization review activities including but not limited to precertification ensures appropriate level of care and status (Inpatient Outpatient and Observation) throughout admission and performs concurrent reviews / retrospective reviews according to guidelines. Determines the medical necessity of requests by performing first level reviews. The UM nurse ensures a process that is efficient for providing care ensuring timely and appropriate levels of care for the incoming patients. UM RN is responsible for preparing cases for Physician Advisor for 2

nd

level review.

PIH Health is a nonprofit regional healthcare network that serves approximately 3 million residents in the Los Angeles County Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital PIH Health Good Samaritan Hospital PIH Health Whittier Hospital 37 outpatient medical office buildings a multispecialty medical (physician) group home healthcare services and hospice care as well as heart cancer digestive health orthopedics womens health urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nations top hospital systems for best practices cutting-edge advancements quality of care and healthcare technology. For more information visit or follow us on Facebook Twitter or Instagram.

Required Skills

• Excellent verbal and written communication skills
• Ability to follow chain of command.
• Highly developed ability to multi-task and maintain focus
• Proactive can-do approach and desire to build positive working relationships through collaborative

problem-solving

and prioritization skills with minimal supervision.

Key Skills

Abinitio,Administration And Accounting,Android,Bid Management,Inventory Management,Embedded C

Employment Type : Unclear

Experience : years

Vacancy : 1

Monthly Salary Salary : 53 - 79