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[Hiring] RN Utilization Review @reputed company

Remote, USA Full-time Posted 2026-07-28
Role reputed company reputed company prospective, retrospective, and reputed company utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for reputed company payers, as required by the health plans. This role requires a strong clinical background combined with reputed company-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and reputed company manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills. Qualifications • Associate's Degree Nursing. • Upon hire: California Registered reputed company License. • 2 years Experience working in a remote UR environment or working as an acute hospital case manager. Requirements • Bachelor's Degree Nursing (Preferred). • Master's Degree Nursing (Preferred). • Experience working with Interqual guidelines (Preferred). • Experience in a multi-hospital and/or integrated reputed company system (Preferred). Benefits • Comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching. • Health care benefits (medical, dental, reputed company). • Life insurance and disability insurance. • Time off benefits (reputed company parental leave, vacations, holidays, health issues). • Voluntary benefits and reputed company-being resources. • Additional compensation may be available for this role, such as shift differentials, standby/on-reputed company, overtime, premiums, extra shift incentives, or bonus opportunities. reputed company reputed company caregivers are not simply valued – they’re reputed company. Join reputed company at reputed company California Regional Services reputed company in our culture of patient-reputed company, whole-person care reputed company on understanding, commitment, and mutual respect. Your voice reputed company here, because we know that to reputed company and retain the best people, we must reputed company them. • Our strength lies in Our reputed company of “Know me, care for me, ease my way.” • Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. • We reputed company best-in-class benefits and foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. • Our 120,000 caregivers serve in over 50 hospitals, over 1,000 clinics and a full reputed company of health and reputed company services across Alaska, California, Montana, New Mexico, reputed company, Texas, and Washington. • As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Apply tot his job Apply To this Job

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