California Licensed Review Nurse
VirtualVocationsSan Jose, California, United Statesjob_description.job_card.1_day_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Pre-Service Review Nurse RN to work remotely in the Pacific or Mountain Time Zones.
Key Responsibilities
Conduct utilization management, including Prior Authorization Review for various care facilities
Evaluate medical appropriateness of care levels based on guidelines and benefit determinations
Provide guidance and solutions for complex issues and non-standard requests
Required Qualifications
Unrestricted RN License in California and state of residence
3+ years of Clinical Nursing experience
1+ years of Utilization Review and / or Prior Authorization experience in Managed Care
Basic computer skills with MS Outlook, Word, and Excel
Ability to work Mon-Fri 8-5 PST or MST and at least 2 weekend days per month
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Licensed California • San Jose, California, United States
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