RN Utilization Management

A large managed care organization is seeking an experienced Utilization Management RN with previous clinical experience and strong computer skills to work in a fast-paced environment. Note: Employer requires you must be fully vaccinated for COVID-19 Work Location: 7 Technology Drive, Irvine , CA 92618 Pay: $40.00 Contract Dates: Asap to 1/212022 Hours: Mon-Fri, Day shift (40 hours a week) Responsibilities Review Prior Authorization requests via computer in an assigned queue Assess the requested service(s) against the clinical information; identify appropriate criteria to be used to evaluate the request Prepare and document all findings; approve authorizations that are within the nurse''s scope to approve; prep all authorizations that need physician review for possible denial Meet all regulatory turn-around times and documentation requirements Participate in team huddles and discussions; be open to ideas and changes in processes

Created: 2021-11-29