RanchoCucamongaRecruiter Since 2001
the smart solution for Rancho Cucamonga jobs

Utilization Review Nurse -

Location: Rancho Cucamonga
Posted on: April 8, 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!

I'm looking for
in category
within


Other Healthcare Jobs


School Speech Language Pathologist
Description: Job Description Full-time School Speech Language Pathologist, Lake Elsinore,
Company: Soliant
Location: Lake Elsinore
Posted on: 04/11/2021

RN PACU Pre / Post Anesthesia - Travel Nurse
Description: Travel Nurses Needed - Surgical Services br Nationwide Travel RN Nursing JobsPACU Pre-Op / Post-Op Recovery RoomPost Anesthesia Care Unit Registerd Nurse br Post Anesthesia CareHCEN has numerous request (more...)
Company: RN Travel HealthCare Jobs
Location: Placentia
Posted on: 04/11/2021

Dental Assistant - Interviewing Now! (129661)
Description: A Full Service Medical Group, with 17 locations, is looking for bilingual Dental Assistants How to Apply: --Give us a call
Company: MediQuest Staffing
Location: Paramount
Posted on: 04/11/2021


RN (F/T) (Poway,CA)
Description: JOIN OUR TEAM AT OTAY MESA AND MAKE A DIFFERENCE At CoreCivic, we do more than manage inmates, we care for people. CoreCivic is currently seeking Registered Nurses who have a passion for providing (more...)
Company: CoreCivic
Location: Poway
Posted on: 04/11/2021

Travel Nurse RN - NICU Neonatal Intensive Care
Description: Nationwide Travel Nurse Jobs - Neonatal Intensive Care RNAre 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: 04/11/2021

Cath Lab Registered Nurse - Travel RN
Description: Travel Nurses Needed - Cardiac Services br Nationwide Travel Cath Lab RN Nursing Jobs br Looking for a Cardiac Cath Lab travel assignment You are in the right place, the HCEN Network of staffing (more...)
Company: RN Travel HealthCare Jobs
Location: Yucaipa
Posted on: 04/11/2021

RN Travel Nurse Surgical Intensive Care Unit (SICU)
Description: Travel Nurses Needed - SICU br Nationwide Surgical Intensive Care Unit Nursing JobsHCEN has numerous request for RN Candidate Profiles Looking for a Intensive Care Unit travel assignment You are in (more...)
Company: RN Travel HealthCare Jobs
Location: Santee
Posted on: 04/11/2021

ICU, MICU - Medical Intensive Care Units - Travel RN
Description: Travel Nurses Needed - RN Intensive Care Units br Nationwide Registered Nurse Travel Jobs br The Travel Nurse Season is here and it showsFind great travel assignments with the best in compensation (more...)
Company: RN Travel HealthCare Jobs
Location: Rosemead
Posted on: 04/11/2021

Speech Language Pathologist (SLP) Travel & Locum
Description: Nationwide Travel Locum Therapist Jobs - Speech Language Pathologist Are you looking for a new therapist job Would you like to spend the season somewhere you've never been Hospitals, Clinics, Outpatient, (more...)
Company: HCEN Travel Solutions
Location: Yucaipa
Posted on: 04/11/2021

Home Care Caregiver - Urgent Need, bonus offered
Description: No Certification No Problem We are hiring caregivers of all skill levels to provide compassionate In Home Care to some of our friendly senior clientele. Our caregivers enjoy perks like
Company: CareInHomes
Location: Paramount
Posted on: 04/11/2021

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Rancho Cucamonga RSS job feeds