RN or Licensed Vocational Nurse UM/Quality Improvement Job

REGISTERED NURSE OR LICENSED VOCATIONAL NURSE UM/QUALITY IMPROVEMENTneeded for a FULL TIME/CONTRACT opportunity with Yoh's client located in Irvine, CA.

TOP SKILLS SHOULD YOU POSSESS:

- Registered Nurse or Licensed Vocational Nurse in State of CA
- Two - five (2-5) years of Utilization Management/Quality Improvement in an IPA Setting
- Health Plan Regulatory Experience

WHAT YOU'LL BE DOING:

- Responsible for Utilization Management, Quality Improvement in an IPA Setting
- Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
- Perform utilization review, or concurrent review (on-site or telephonic inpatient care management)

WHAT YOU NEED TO BRING TO THE TABLE:

- Registered Nurse or Licensed Vocational Nurse in State of CA (Active and in Good Standing)
- Bachelors Degree in Nursing preferred from Accredited Nursing School
- Two - five (2-5) years Utilization Management and Quality Improvement Experience
- Knowledge of Milliman Criteria
- Health Plan Regulatory Experience
- Two - five (2-5) years of direct patient care experience in ICU, Tele or ED required
- Intermediate level use of MS Word, Excel and Outlook
- Strong communication and interpersonal skills

OPPORTUNITY IS CALLING, APPLY NOW!

RECRUITER:Christine Torres  

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Contact us if you are an individual with a disability and require accommodation in the application process.

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