UM Review Nurse

Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Compensation: $30.00 - $34.00 / hour Department: Health Services (HS - UM) Job Title Utilization Management Review Nurse About the Role Astrana Health is looking for a Utilization Review Nurse to assist our Health Services Department. This hybrid position requires availability Monday–Sunday from 8:00 AM to 8:00 PM, including weekends and holidays as needed. What You’ll Do Complete prior authorization/retrospective reviews of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment. Refer cases to Medical Directors as needed or appropriate. Maintain knowledge of state and federal regulations and accreditation standards. Comply with internal policies and procedures. Perform any other job duties as requested. Qualifications Active, unrestricted LVN license in California. Experience with Microsoft applications such as Word, Excel, and Outlook. You’ll be Great for this Role If Two (2) years of health plan, IPA, or MSO experience. Strong interpersonal skills. Ability to collaborate with co‑workers, senior leadership, and other management. Experience educating and training staff. Environmental Job Requirements & Working Conditions Hybrid schedule; office located at 1600 Corporate Center Drive, Monterey Park, CA. Typical business hours Monday–Friday 8:30 AM–5 PM; open availability 8 AM–8 PM PST, Monday–Sunday; five shifts per week with weekend and holiday coverage. Overtime required. Target pay range $30.00–$34.00 per hour; actual compensation based on location, experience, and job factors. Equal Employment Opportunity Astrana Health is a proud Equal Employment Opportunity and affirmative action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, veteran status, disability status, or any other legally protected characteristic. All employment is decided based on qualifications, merit, and business need. If you require assistance applying due to a disability, please email View email address on click.appcast.io for accommodation. Additional Information The job description does not constitute an employment agreement and is subject to change by the employer as needs and requirements evolve. #J-18808-Ljbffr