Utilization Review Nurse -
Location: Rancho Cucamonga
Posted on: January 14, 2021
|
|
Job Description:
Great opportunity for a Utilization Review RN.
Required Skills:
?Approves requests for medical services (inpatient,
pre-certification and concurrent, and outpatient) based on
available information, utilizing nationally accepted guidelines for
utilization management (InterQual) as well as standard of care
information and clinical judgment as appropriate.
?Requests clinical information when needed and refers the request
to secondary medical review with the appropriate information, when
approval for the request cannot be given by the nurse.
?Identifies need for referral of the member to case management
and/or disease management services based on established referral
criteria or individual care need identified during interaction with
members or providers.
?Follows established policy and procedures for timely medical
necessity review, escalation, Peer Review and appeals meeting all
state, URAC and applicable regulatory guidelines.
?Serves as a facilitator to providers for resolution of provider
concerns, complaints and grievances.
?Maintains and ensures the confidentiality of all information
collected during the review process.
?Participates in medical necessity, URAC, clinical and quality
training programs as requested.
?Communicates with providers and members as needed.
?Maintain a positive professional and respectful attitude with
peers and clients.
?Determine and monitor appropriate discharge plans for all approved
services.
We are an equal employment opportunity employer and will consider
all qualified candidates without regard to disability or protected
veteran status.
Keywords: , Rancho Cucamonga , Utilization Review Nurse -, Healthcare , Rancho Cucamonga, California
Click
here to apply!
|
Didn't find what you're looking for? Search again!
Other Healthcare JobsTherapist / Physical Therapist Job in Rosemead, California / Skilled N Description: PT for Rosemead, CA. SNF setting. br Experienced Physical Therapist treating patients with various conditions this will provide you with a wide range of expertise and career development. Company: MAS Medical Staffing Location: Rosemead Posted on: 01/24/2021 Travel Nurse RN Neonatal Intensive Care (NICU) Description: Nationwide Travel Nurse Jobs - Neonatal Intensive Care RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...) Company: HCEN Location: Santee Posted on: 01/24/2021 Medical Surgical RN Travel Nurse Assignments - Med Surg Description: Medical Surgical RN - Nationwide Travel Nurse Assignments Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...) Company: HealthCare Traveler Jobs Location: Yucaipa Posted on: 01/24/2021 Salary in Rancho Cucamonga, California Area | More details for Rancho Cucamonga, California Jobs |Salary Surgery Department - Special Procedures Travel RN Description: Travel Surgery Nurses Needed - Special Procedures RNs Nationwide Travel RN Nursing Assignments br br Looking for a Surgical Services travel assignment You are in the right place, the HCEN Network (more...) Company: RN Travel HealthCare Jobs Location: Yucaipa Posted on: 01/24/2021 Travel RN Pediatrics Intensive Care (PICU) Description: Nationwide Travel Nurse Jobs - Pediatric Intensive Care RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for (more...) Company: HCEN Location: Santee Posted on: 01/24/2021 Registered Nurse (MS/TELE), 110/Hour, Orange County, CA Description: Job Description-Registered Nurse Med-Surg/Tele/DOU --Job Summary: Hospital in Anaheim, CA--is looking for RN's to start Immediately in there DOU/Tele/Med-Surg units. The Company: Astrya Global Location: Rowland Heights Posted on: 01/24/2021 Respiratory Therapist / RRT - Travel Contracts Description: Respiratory Therapist RRT, CRT Locum Tenens Travel Assignments br Looking for that perfect Respiratory Therapist Job, this is the best resource. One quick More Info Request gets you in front of the (more...) Company: HealthCare Traveler (Allied Health) Location: Rosemead Posted on: 01/24/2021 Pediatric's Travel Nurse (Peds RN) Description: Travel Nurses Needed - Pediatric RN Specialties br Nationwide Pediatric Travel Nursing JobsPediatric Intensive Care Unit, Pediatrics, Pediatric OncologyHCEN has numerous request for RN Candidate Profiles (more...) Company: RN Travel HealthCare Jobs Location: Santee Posted on: 01/24/2021 LVN - El Cajon, CA (Full-Time) Description: Job Description The Licensed Vocational Nurse LVN / Licensed Practical Nurse LPN in expanded scope clinics is an integral part of the clinic team inside of MinuteClinic. Under the supervision of a (more...) Company: CVS Health Location: Santee Posted on: 01/24/2021 Travel Nurse RN Open Heart Intensive Care (CVICU) Description: Nationwide Travel Nurse Jobs - Cardiac Intensive Care Unit RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for (more...) Company: HealthCare Employment Network Location: Santee Posted on: 01/24/2021 |