California Licensed Utilization Management RN

Company: VirtualVocations
Location: Aurora
Posted on: November 3, 2024

Job Description:

A company is looking for an RN, Utilization Management - Remote.

Key Responsibilities

Perform all functions of a UM nurse reviewer and compose compliant denial letters
Ensure accurate clinical decision-making and documentation for adverse determinations
Collaborate with UM compliance for quality improvement and escalate non-compliance cases

Required Qualifications

Graduation from an accredited school of nursing
Active, unrestricted Registered Nurse license through the State of California
3+ years of care management, utilization review, or discharge planning experience
Bachelor of Science in Nursing (BSN) preferred
HMO experience preferred

Keywords: VirtualVocations, Racine , California Licensed Utilization Management RN, Executive , Aurora, Wisconsin

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