Utilization Review Nurse

About This Role

This 13-week contract opportunity in California is for an experienced Utilization Review Nurse (RN) with the potential for a permanent position. The role involves reviewing patient medical records and clinical documentation to ensure medical necessity and appropriateness of care.

Responsibilities

• Review patient medical records and clinical documentation for medical necessity and appropriateness of care
• Perform utilization management and utilization review activities
• Evaluate patient admissions and continued stays according to established clinical criteria
• Collaborate with physicians and healthcare teams regarding patient care and utilization decisions
• Maintain accurate documentation and ensure compliance with healthcare policies and procedures
• Support effective resource utilization and quality patient care
• Provide holiday coverage as required

Requirements

• Active California RN license
• Minimum of 3 years of nursing experience
• Previous Utilization Management experience required
• Current BLS and ACLS certifications
• Proof of a negative TB screening within the past 12 months
• Availability to work five 8-hour shifts per week
• Willingness to work holidays as required

Important Details

• Schedule: five 8-hour shifts per week, includes holiday coverage
• Contract: 13-week contract, with potential for a permanent position

Application Process

• Submit proof of a negative TB screening within the past 12 months