Remote Utilization Review Nurse (CA) - Managed Care
SPECTRAFORCE
Spectraforce is seeking an Utilization Review Registered Nurse (Post-service Medical Review 3) for remote work in California. The role focuses on retrospective utilization reviews, medical necessity assessments, and line-by-line audit of hospital bills to ensure contract compliance and proper billing practices. Strong RN credentials in California and CMS guideline proficiency are required. Ideal candidates will have 5+ years in managed care, experience with inpatient reviews, and solid EMR and #J-18808-Ljbffr
Vacancy posted 5 days ago
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