Talent.com
Southwest Healthcare System
RN Central Utilization Review NurseSouthwest Healthcare System • TEMECULA, California
RN Central Utilization Review Nurse

RN Central Utilization Review Nurse

Southwest Healthcare System • TEMECULA, California
30+ days ago
Job type
  • Full-time
Job description

Job Description

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, 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.

Job Summary:

The Southwest Healthcare Regional office in Temecula, CA is seeking a Full-Time 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 days of employment.
  • Must be available to work weekends and holidays.

Qualifications

Experience/Training/Experience:

  • Associates degree in Nursing or Graduate of a Vocational Nursing school required.
  • Two (2) years of clinical experience in an acute care hospital setting with (1) year in an inpatient or outpatient case management setting required.

Certifications/Licenses:

  • Current license as a RN in the State of California required.

Other Skills and Abilities:

  • Demonstrates knowledge and ensures compliance with the Nurse Practice Act, The Joint Commission and Title standards and guidelines.
  • Demonstrates compliance with hospital policies and procedures at all times.
  • Demonstrates strong leadership, organization, communication and interpersonal skills.
  • Demonstrates ability to relate to clinical personnel and medical staff, as well as ability to interact well with the public.
  • Must have knowledge of PC and applications.
  • Capable of resolving escalated issues arising from operations and requiring coordination with other
  • Knowledgeable in Interqual guidelines.

Benefit Highlights:

  • Challenging and rewarding work environment.
  • Competitive Compensation & Generous Paid Time Off.
  • Excellent Medical, Dental, Vision and Prescription Drug Plans.
  • (K) with company match and discounted stock plan.
  • SoFi Student Loan Refinancing Program.
  • Tuition, CEU, Certification, Licenses Reimbursement program.
  • Career development opportunities within UHS and its + Subsidiaries!

Southwest Healthcare is owned and operated by subsidiaries of , 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.

Create a job alert for this search

RN Central Utilization Review Nurse • TEMECULA, California

Similar jobs

Travel Nurse - RN - OR - Operating Room - $2719 / Week - Hiring Now

LRS Healthcare - NursingSantee, CA, US
Full-time

LRS Healthcare - Nursing is seeking an experienced Operating Room Registered Nurse for an exciting Travel Nursing job in San Diego, CA.Shift: Inquire Start Date: 06/15/2026 Duration: 13 weeks Pay: ... Show more

 • Promoted

Travel Nurse - RN - LD - Labor and Delivery - $2220.36 / Week

Atlas MedStaffSan Marcos, CA, US
Full-time

Atlas MedStaff is seeking an experienced Labor and Delivery Registered Nurse for an exciting Travel Nursing job in San Diego, CA.Shift: 3x12 hr days Start Date: 06/08/2026 Duration: 13 weeks Pay: $... Show more

 • Promoted

LVN Dispensing Nurse

Acadia Healthcare Inc.Escondido, CA, United States
Full-time

Outpatient MAT Opioid Treatment Program (OTP) Seeking: LVN Dispensing Nurse Full Time Hours: Early morning hours offering a great work/life balance! * Monday - Friday: 5:20 AM - 1:50 PM * Rotati... Show more

 • Promoted

Physical Therapist Home Health

CoxHealthHome Support
Full-time

Provides in-home evaluation, direction, and application of Physical Therapy services to relieve pain, develop or restore function, and/or maintain maximum physical performance of patient.Education:... Show more

 • Promoted

Travel Nurse - RN - OR - Operating Room - $3029.91 / Week - Hiring Now

Coast Medical ServiceSan Marcos, CA, US
Full-time

Coast Medical Service is seeking an experienced Operating Room Registered Nurse for an exciting Travel Nursing job in San Diego, CA.Shift: 3x12 hr days Start Date: 06/15/2026 Duration: 13 weeks Pay... Show more

 • Promoted

Physician (MD/DO) - Neurology - General/Other in Temecula, CA

LocumJobsOnlineTemecula, CA, US
Full-time

Doctor of Medicine | Neurology - General/Other.Competitive weekly pay (inquire for details) .LocumJobsOnline is working with The Inline Group to find a qualified Neurology MD in Temecula, Californi... Show more

 • Promoted

Travel Nurse - RN - OR - Operating Room

Medical SolutionsEscondido, CA, US
Full-time

Medical Solutions is seeking an experienced Operating Room Registered Nurse for an exciting Travel Nursing job in Escondido, CA.Shift: 2x12 hr days Start Date: 05/25/2026 Duration: 13 weeks.A facil... Show more

 • Promoted

Night-Shift RN: Surgical Acute Care

Scripps HealthEscondido, California, United States
Full-time

Scripps Health is seeking dedicated RNs for full-time positions working 12-hr NIGHT shifts at Scripps Mercy San Diego in Hillcrest.Join a compassionate team known for its commitment to patient-cent... Show more

 • Promoted • New!

Home Infusion Nurse - PRN

Source One Management Services, LLCTemecula, California, United States
Full-time

We are seeking an infusion nurse (RN) with IVIg experience interested in providing in-home infusions for a local patient.Infusion Details Medication: Gammagard 35 gm (350 mL) intravenously once da... Show more

 • Promoted

Travel Nurse - RN - Oncology - $2305.39 / Week - Hiring Now

Cynet HealthSan Marcos, CA, US
Full-time

Cynet Health is seeking an experienced Oncology Registered Nurse for an exciting Travel Nursing job in San Diego, CA.Shift: 4x10 hr days Start Date: 06/15/2026 Duration: 13 weeks Pay: $2305.Ranked ... Show more

 • Promoted

Nurse - Earn Up to $37/hr

TradeJobsWorkforce92150 San Diego, CA, US
$37.00 hourly
Full-time

We are seeking a Nurse Practitioner or Physician Assistantwith experience in the following job duties: Contributes to physician's effectiveness by identifying short-term and long-range patient car... Show more

 • Promoted

LVN Dispensing Nurse

Acadia HealthcareEscondido, California, United States
Full-time

Overview Outpatient MAT Opioid Treatment Program (OTP) Seeking: LVN Dispensing Nurse Full Time Hours: Early morning hours offering a great work/life balance! Monday - Friday: 5:20 AM - 1:50 PM... Show more

 • Promoted

Travel Occupational Therapist (OT) in Temecula, CA

AlliedTravelCareersTemecula, CA, US
Full-time

Competitive weekly pay (inquire for details) .AlliedTravelCareers is working with TNAA | TotalMed to find a qualified Occupational Therapist (OT) in Temecula, California, 92589!.Travel Nurse Across... Show more

 • Promoted

Medical Provider, MD San Jacinto Health Center

DAP HealthSan Jacinto, CA, US
Full-time

Under the direction of the CMO, delivers primary care and supervises mid-levels and clinical support staff.Provides continuing, comprehensive health maintenance and medical care to entire families ... Show more

 • Promoted

Travel Nurse RN - Operating Room - $3,304 per week in San Marcos, CA

TravelNurseSourceSan Marcos, CA, US
Full-time

Registered Nurse (RN) | Operating Room.TravelNurseSource is working with FlexCare to find a qualified OR RN in San Marcos, California, 92078!.Call-off Policy Log in to view.First Offer = Best Offer... Show more

 • Promoted

Travel Nurse - RN - OR - Operating Room - $3071 / Week - Hiring Now

Fusion Medical StaffingSan Marcos, CA, US
Full-time

Fusion Medical Staffing is seeking an experienced Operating Room Registered Nurse for an exciting Travel Nursing job in San Diego, CA.Shift: Inquire Start Date: ASAP Duration: 13 weeks Pay: $3071 /... Show more

 • Promoted

Travel Nurse - RN - CVOR - Cardiovascular Operating Room - $3473 / Week - Hiring Now

Stability HealthcareSan Marcos, CA, US
$347.00 weekly
Full-time

Stability Healthcare is seeking an experienced Cardiovascular Operating Room Registered Nurse for an exciting Travel Nursing job in San Diego, CA.Shift: 3x12 hr flex Start Date: ASAP Duration: 13 w... Show more

 • Promoted

Clinical RN II- Intensive Care Unit

Palomar HealthEscondido, California, United States
Full-time

Primarily responsible for the delivery of coordinated nursing care for a patient or an assigned group of patients within an assigned unit and for the day-to-day management and supervision of the re... Show more

 • Promoted

Travel Nurse - RN - ICU - Intensive Care Unit - $2321.48 / Week

FlexCareSantee, CA, US
Full-time

FlexCare is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in San Diego, CA.Shift: 3x12 hr nights Start Date: ASAP Duration: 13 weeks Pay: $2321.Leve... Show more

 • Promoted

Rheumatology 1 Hour From San Diego, CA; $350K Base Salary

CHG HealthcareTemecula, CA, US
Full-time

Temecula is a city in southern California.It is known for the surrounding Temecula Valley Wine Country, with its hillside vineyards and many golf courses.Your specialty-specific CompHealth rep plac... Show more