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Utilization review nurse [h1.location_city]

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Utilization review nurse • chula vista ca

[last_updated.last_updated_variable_hours]
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Utilization Review RN

Utilization Review RN

VirtualVocationsChula Vista, California, United States
[job_card.full_time]
A company is looking for a Utilization Review Registered Nurse (Multiple Openings).Key Responsibilities Perform utilization review using InterQual and / or MCG / Milliman criteria Collaborate with p...[show_more][last_updated.last_updated_variable_hours]
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Care Review Processor-Utilization Review-California

Care Review Processor-Utilization Review-California

San Diego StaffingSan Diego, CA, US
[job_card.full_time]
Provides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting provision of integrated delivery of care across the continuum.Con...[show_more][last_updated.last_updated_variable_days]
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Travel Nurse RN - Utilization Review - $82 per hour in Carmichael, CA

Travel Nurse RN - Utilization Review - $82 per hour in Carmichael, CA

TravelNurseSourceSan Diego, California, US
[job_card.full_time]
Registered Nurse (RN) | Utilization Review.United Health Care Staffing, Inc.TravelNurseSource is working with United Health Care Staffing, Inc. Utilization Review RN in carmichael, California, 95608...[show_more][last_updated.last_updated_variable_days]
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Utilization Management (UM) Manager

Utilization Management (UM) Manager

Astiva Health, IncSan Diego, CA, US
[job_card.full_time]
Orange, CA is a premier healthcare provider specializing in Medicare and HMO services.With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize acc...[show_more][last_updated.last_updated_variable_hours]
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Utilization Management LVN - Hybrid

Utilization Management LVN - Hybrid

OptumSan Diego, CA, United States
[job_card.full_time]
We're going beyond basic care to health programs integrated across the entire continuum of care.Optum's Pacific West region is redefining health care with a focus on health equity, affordability, q...[show_more][last_updated.last_updated_30]
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Behavioral Health Utilization Review Specialist

Behavioral Health Utilization Review Specialist

Spectrum Billing SolutionsSan Diego, CA, United States
[job_card.full_time]
Behavioral Health Utilization Review Specialist.Spectrum Billing Solutions provides top-notch revenue cycle management services tailored for healthcare providers. Our expert team leverages extensive...[show_more][last_updated.last_updated_variable_days]
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Senior Utilization Management Nurse

Senior Utilization Management Nurse

Blue Shield of CASan Diego, CA, United States
[job_card.full_time]
The Facility Compliance Review team plays a crucial role in ensuring that post-service prepayment facility claims adhere to contract compliance, industry billing standards, and medical necessity.As...[show_more][last_updated.last_updated_variable_days]
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First Vice President of Appraisal Review

First Vice President of Appraisal Review

CBRESan Diego, CA, United States
[job_card.full_time]
As a First Vice President of Appraisal Review with CBRE, you will play a pivotal role in collaborating with our leadership team to enhance the appraisal review processes. You will ensure that our se...[show_more][last_updated.last_updated_variable_days]
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Utilization Review Technician II

Utilization Review Technician II

Paradise Valley HospitalNational City, CA, United States
[job_card.full_time]
Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Paradise Valley Hospital, a member of Prime Healthcare, offers incredible op...[show_more][last_updated.last_updated_variable_hours]
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Registered Nurse Manager - Utilization Review & Case Management

Registered Nurse Manager - Utilization Review & Case Management

MDA EdgeSan Diego, CA, US
[job_card.full_time]
Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center.Ensures cost effective and quality patient care by appropriate utilization of resourc...[show_more][last_updated.last_updated_variable_days]
Utilization Management Resource Coordinator Sharp Spectrum Corporate Offices Full-Time Variable Shift

Utilization Management Resource Coordinator Sharp Spectrum Corporate Offices Full-Time Variable Shift

Sharp HealthCareSan Diego, California, USA
[job_card.full_time]
Hourly Pay Range (Minimum - Midpoint - Maximum) : .The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position w...[show_more][last_updated.last_updated_variable_days]
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Travel Nurse RN - Case Manager, Utilization Review - $2,335 per week

Travel Nurse RN - Case Manager, Utilization Review - $2,335 per week

Medical SolutionsSan Diego, CA, USA
[job_card.full_time]
Travel Nurse RN - Case Manager, Utilization Review - $2,335 per week at Medical Solutions summary : .The Travel Nurse RN - Case Manager, Utilization Review position offers healthcare professionals a ...[show_more][last_updated.last_updated_variable_days]
Behavioral Health Utilization Mgmt Clinician, Senior

Behavioral Health Utilization Mgmt Clinician, Senior

Blue Shield of CaliforniaSan Diego, CA, United States
[job_card.full_time]
The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, an...[show_more][last_updated.last_updated_variable_days]
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Care Review Processor-Utilization Review-California

Care Review Processor-Utilization Review-California

Molina HealthcareSan Diego, CA, United States
[job_card.full_time]
JOB DESCRIPTION Job SummaryProvides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting provision of integrated delivery of ca...[show_more][last_updated.last_updated_variable_days]
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Registered Nurse Manager - Utilization Review & Case Management

Registered Nurse Manager - Utilization Review & Case Management

Macpower Digital Assets EdgeSan Diego, CA, United States
[job_card.full_time]
Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center.Ensures cost effective and quality patient care by appropriate utilization of resourc...[show_more][last_updated.last_updated_variable_days]
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Travel Nurse RN - Utilization Review in Torrance, CA

Travel Nurse RN - Utilization Review in Torrance, CA

Travel Nurse SourceSan Diego, CA, United States
[job_card.full_time]
Registered Nurse (RN) | Utilization Review.Competitive weekly pay (inquire for details).TravelNurseSource is working with IMCS Group Inc to find a qualified Utilization Review RN in Torrance, Calif...[show_more][last_updated.last_updated_1_day]
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Utilization Review-Case Management (Full-Time)

Utilization Review-Case Management (Full-Time)

Aurora San DiegoSan Diego, CA, United States
[job_card.full_time]
Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for extern...[show_more][last_updated.last_updated_30]
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Clinical Review Medical Director - Vascular Surgery - Remote

Clinical Review Medical Director - Vascular Surgery - Remote

UnitedHealth GroupSan Diego, CA, United States
[filters.remote]
[job_card.full_time]
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connect...[show_more][last_updated.last_updated_30]
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Utilization Review Technician II

Utilization Review Technician II

Prime HealthcareNational City, CA, United States
[job_card.full_time]
Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Paradise Valley Hospital, a member of Prime Healthcare, offers incredible op...[show_more][last_updated.last_updated_variable_hours]
Utilization Review RN

Utilization Review RN

VirtualVocationsChula Vista, California, United States
[job_card.variable_hours_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

A company is looking for a Utilization Review Registered Nurse (Multiple Openings).

Key Responsibilities

Perform utilization review using InterQual and / or MCG / Milliman criteria

Collaborate with providers and internal teams to ensure appropriate level of care

Document reviews and decisions accurately within the EMR (EPIC preferred; Cerner second)

Required Qualifications

Active RN license (state-specific or compact, as applicable)

Strong clinical background (acute care or similar); clinical strength prioritized over extensive UM history

Experience with InterQual and / or MCG / Milliman

EMR experience required (EPIC preferred, Cerner a plus)

Ability to commit to a fixed schedule for the entire contract (no schedule changes once agreed upon)