RN - Utilization Review - Apple Valley, CA - RN26-06574

Job Description

Job Description

Job Title: Registered Nurse – Utilization Review
Location: Apple Valley, CA
Type: Contract

Position Overview:
Navitas Healthcare, LLC is seeking Registered Nurse – Utilization Review for an exciting Travel or Local job in Apple Valley, CA.

Responsibilities:

• Perform utilization review activities for inpatient admissions and continued stays
• Evaluate medical necessity using established clinical criteria and guidelines
• Collaborate with physicians, case managers, social workers, and interdisciplinary teams to support appropriate patient care and resource utilization
• Conduct concurrent reviews and identify opportunities to improve patient throughput and length of stay
• Ensure compliance with CMS, regulatory, and payer requirements
• Document utilization review findings accurately and timely
• Participate in discharge planning discussions and care coordination activities
• Monitor denials, appeals, and authorization processes as required
• Maintain communication with insurance providers and healthcare teams regarding patient status and coverage determinations

Requirements:

• Minimum 3 years of acute care Utilization Review and/or Care Management experience required
• Must have recent hospital-based utilization review experience
• Experience with health plans, insurance companies, or medical groups alone will not be considered
• Previous travel assignment experience required
• Active California Registered Nurse (RN) License required
• Pending California RN License accepted; must be active prior to start date

Preferred Qualifications:

• Seasoned traveler strongly preferred

For more details contact at View email address on ziprecruiter.com or Call / Text at View phone number on ziprecruiter.com.

About Navitas Healthcare, LLC: It is a Joint Commission Certified / WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.