RN, Hospital

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California

Assignment Duration

This is a 13-week contract position.

Schedule / Shift

Day shift, 5 days a week from 08:00 to 16:30 PST.

Job Description

We are seeking a dedicated professional to join our utilization review team in a remote capacity. This role requires strong experience in acute hospital settings, specifically in utilization management, performing concurrent reviews, and ensuring compliance with evidence-based guidelines.

Responsibilities

• Conduct utilization reviews for inpatient, extended hospital outpatient, and OBS services.
• Utilize InterQual criteria to determine medical necessity and support care coordination.
• Perform retrospective and concurrent reviews, including continued stay reviews.
• Document findings and collaborate with interdisciplinary teams as needed.

Required Experience

• Minimum of 3 years of charge experience in an acute hospital setting.
• Experience using the Epic charting system within the last 6-12 months.
• Familiarity with Medicare regulations and utilization management processes.

Certifications / Licensure

• A valid California nursing license is required.
• Proficient in utilization management certifications preferred.

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