California Licensed Utilization Management Nurse
VirtualVocationsBrownsville, Texas, United Statesjob_description.job_card.variable_hours_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 UM Nurse, RN for the Weekend Shift.
Key Responsibilities
Conduct prospective and concurrent / retrospective reviews of referrals to ensure compliance with regulatory requirements
Utilize nationally recognized UM criteria to meet Member needs effectively
Support the Quality Program goals including HEDIS, CAHPS, and NCQA Accreditation
Required Qualifications
Two or more years of utilization management experience in a healthcare delivery setting or an acute care facility
Experience in an HMO or Managed Care setting is preferred
High school diploma or GED required; Bachelor's degree in Nursing preferred
Possession of an active, unrestricted Registered Nurse (RN) license issued by the California BRN
Valid California Driver's license is required
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Utilization Management Nurse • Brownsville, Texas, United States
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