Utilization Review Nurse Job

UTILIZATION REVIEW NURSE needed for a CONTRACT opportunity with Yoh's client located in South San Francisco, CA.

Top Skills You Should Possess:

- Utilization review/utilization management
- Medicare & Medi-Cal

What You'll Be Doing:

- Conduct onsite reviews at inpatient facilities, including acute care, and/or process authorization requests for various services including but not limited to: outpatient, rehabilitation and/or home health services
- Review authorization requests for out-of-network inpatient facilities
- Provide care coordination of members who are transitioning from one level of care to another
- Provide back-up for other UR Nurses as needed

What You Need to Bring to the Table:

- California RN license
- Five years clinical nursing experience
- Experience with utilization management, disease management, and coordination of care within a managed care environment
- Knowledge of San Mateo County provider community and community resources
- Knowledge of Medicare and Medi-Cal coverage requirements and regulatory guidelines

Bonus Points! Otherwise Known As Preferred Qualifications:

- Bachelor's degree in nursing or a related health services field

WHAT ARE YOU WAITING FOR? APPLY NOW!

RECRUITER: Jennifer Andersen

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

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