A company is looking for a Temp Utilization Review Nurse.
Key Responsibilities
Review medical records to determine the medical necessity of treatment requests based on evidence-based guidelines
Evaluate treatment protocols and make recommendations, including negotiating with providers as needed
Communicate UR determinations with claims examiners, providers, and other stakeholders within prescribed time frames
Required Qualifications, Training, and Education
Minimum of 3 years clinical experience
Experience in California Worker's Compensation and Managed Care / Utilization Review is desired
Familiarity with California Worker's Compensation regulations and medical terminology
Completion of IEA CA10 is required within one year of employment
Ability to direct ancillary non-licensed personnel as needed
California Licensed Utilization Review Nurse • Garden Grove, California, United States
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