State Licensed Utilization Review Nurse
VirtualVocationsOrange, California, United States10 hours ago
Job type
- Full-time
Job description
A company is looking for a Utilization Review Nurse (PRN).
Key Responsibilities
Review and evaluate electronic medical records for emergency admissions to assess medical necessity
Apply clinical guidelines to ensure proper utilization of healthcare resources and participate in discussions with physicians
Enter clinical review information for insurance authorization and analyze utilization patterns
Required Qualifications
Current and unrestricted RN license
At least 3 years of clinical experience in an acute care setting
Minimum of 2 years of utilization management experience
Intermediate experience with InterQual and / or MCG criteria
Proficiency in medical record review in an electronic medical record (EMR) system
Create a job alert for this search
Utilization Review Nurse • Orange, California, United States
Related jobs
Position Title : Clinical Review Nurse - Prior Authorization.Work Location : California (Remote).Assignment Duration : 12 months (Possibility to convert.
Work Schedule : Training 8-5PM PST - 4-6 week co...Show moreLast updated: 30+ days ago
Astrana Health is looking for a Utilization Review Nurse to assist our Health Services Department in reviewing.Candidates must be available to work 365 days a year to account for the rotating weeke...Show moreLast updated: 6 days ago
University of California, Irvine, and the only academic health system based in Orange County.UCI Health is comprised of its main campus,.
UCI Health Community Network in Orange and Los Angeles count...Show moreLast updated: 30+ days ago A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Perform concurrent reviews to determine overall health and appropriate level of care for members Review ...Show moreLast updated: 18 hours ago A company is looking for an IBR Clinical Appeals Reviewer - Remote.Key Responsibilities Analyze and respond to IBR Appeals inquiries Perform medical record reviews and prepare written appeals C...Show moreLast updated: 30+ days ago 
Approximately 2-Months, possibley Longer.Under the direction of the Clinical Quality Improvement (CQI) Supervisor, the HEDIS Clinical Review, LVN provides support to the CQI Supervisor, HEDIS Nurse...Show moreLast updated: 30+ days ago
Position Title : Clinical Review Nurse - Prior Authorization.Work Location : California (Remote).Assignment Duration : 12 months (Possibility to convert.
Work Schedule : Training 8-5PM PST - 4-6 week co...Show moreLast updated: 6 days ago University of California, Irvine, and the only academic health system based in Orange County.UCI Health is comprised of its main campus,.
UCI Health Community Network in Orange and Los Angeles count...Show moreLast updated: 2 days ago 
Rehab Without Walls Neuro Rehabilitation.Rehab Without Walls Neuro Rehabilitation.The Clinical Liaison will generate patient referrals and coordinate pre-screens, admissions, and serving as the pri...Show moreLast updated: 23 days ago A company is looking for an IBR Clinical Appeals Reviewer who will analyze and respond to client and hospital claim review appeal inquiries.
Key Responsibilities : Analyze scope and resolution of I...Show moreLast updated: 1 day ago 
Utilization Management Technician Opportunity!!.This Jobot Consulting Job is hosted by : Robert Reyes.Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.Cali...Show moreLast updated: 19 days ago University of California, Irvine, and the only academic health system based in Orange County.UCI Health is comprised of its main campus,.
UCI Health Community Network in Orange and Los Angeles count...Show moreLast updated: 30+ days ago A company is looking for a Utilization Review Nurse (PRN).Key Responsibilities Review and evaluate electronic medical records for emergency admissions to assess medical necessity Apply clinical ...Show moreLast updated: 10 hours ago 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 Re...Show moreLast updated: 1 day ago A company is looking for an RN Medical Reviewer II to perform medical reviews and support medical claims processing.Key Responsibilities Conduct medical claim reviews for complex services and det...Show moreLast updated: 1 day ago 
Coordinator experience, Health Plan Experience, EMR experience, EPIC preferred.You will receive urgent, routine, pre-service, and retro authorization requests, as well as process prior authorizatio...Show moreLast updated: 26 days ago University of California, Irvine, and the only academic health system based in Orange County.UCI Health is comprised of its main campus,.
UCI Health Community Network in Orange and Los Angeles count...Show moreLast updated: 2 days ago A company is looking for a Patient Financial Navigator I.Key Responsibilities Ensure accurate patient medical records, including demographics and insurance coverage Provide financial education t...Show moreLast updated: 30+ days ago 
Association of American Universities and is ranked among the nation's top 10 public universities by U.The campus has produced five Nobel laureates and is known for its academic achievement, premier...Show moreLast updated: 30+ days ago A company is looking for a Clinical Appeals Reviewer.Key Responsibilities Process appeals while ensuring compliance with regulatory milestones Review medical records for documentation and billin...Show moreLast updated: 1 day ago
- Promoted
Clinical Review Nurse - Prior Authorization
Spectraforce TechnologiesLos Angeles, CA, United StatesFull-time
- Promoted
Utilization Review Nurse - Denials
Astrana Health, Inc.Monterey Park, CA, USFull-time
- Promoted
RN Utilization Review - Lakewood - PT Days Exempt
University of California - Irvine HealthLakewood, CA, United StatesFull-time
- Promoted
- New!
LA Licensed Clinical Review Nurse
VirtualVocationsGarden Grove, California, United StatesFull-time
- Promoted
RN Clinical Appeals Reviewer
VirtualVocationsPasadena, California, United StatesFull-time
- Promoted
LVN-HEDIS Clinical Review Nurse 25-00041
Alura Workforce SolutionsRancho Cucamonga, CA, United StatesTemporary
Clinical Review Nurse - Prior Authorization
MediabistroLos Angeles, CA, United StatesFull-time
- Promoted
Medical Assistant / Admit Worker - GHEI Dermatology - FT Days
University of California - Irvine HealthIrvine, CA, United StatesFull-time
- Promoted
Clinical Liaison - Nursing
BrightSpring Health ServicesCulver City, CA, United StatesFull-time
- Promoted
Licensed RN Clinical Appeals Reviewer
VirtualVocationsFullerton, California, United StatesFull-time
- Promoted
Utilization Management Technician
JobotLos Angeles, CA, USFull-time
- Promoted
Medical Assistant / Admit Worker - CAC - Neurology - FT Days
University of California - Irvine HealthIrvine, CA, United StatesFull-time
- Promoted
- New!
State Licensed Utilization Review Nurse
VirtualVocationsIrvine, California, United StatesFull-time
- Promoted
California Licensed Review Nurse
VirtualVocationsOrange, California, United StatesFull-time
- Promoted
South Carolina Licensed RN Reviewer
VirtualVocationsMission Viejo, California, United StatesFull-time
- Promoted
Utilization Management Technician
Axelon Services CorporationLos Angeles, CA, USFull-time
- Promoted
Admitting Worker - Clinic - Surgery ENT- FT Days
University of California - Irvine HealthOrange, CA, United StatesFull-time
- Promoted
Patient Financial Navigator
VirtualVocationsNorwalk, California, United StatesFull-time
- Promoted
Medical Assistant / Admit Worker
University of California - IrvineIrvine, CA, United StatesFull-time
- Promoted
Pennsylvania Licensed Clinical Appeals Reviewer
VirtualVocationsWhittier, California, United StatesFull-time