Utilization Management Nurse

1 week ago Be among the first 25 applicants This range is provided by Pacer Staffing. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $45.00/yr - $52.00/yr Delivery Manager - Healthcare, Client Relationship Manager, VMS/MSPHiring Locums & Physicians/Nurses/Allied/Professional Coder Across with Best pay Location if not remote : Rancho Cordova CA (HYBRID) Travel Required? If so please elaborate. YES May be asked to come to their assigned home office as needed. Duration : 6 months contract to hire role Shift : 8 AM - 5 PM PST Required Skills Must have California RN License Must have Strong Clinical Background with a minimum of 5 years of prior relevant experience doing direct patient care. Must have Strong communication and computer navigation skills office/Excel UM experience with knowledge of MCG Criteria - Nice to have ER and/or ICU experience - Nice to have Medicare experience - Nice to have Disqualifiers/ Dislikes on Resumes: No Clinical experience. Many Short-term Jobs without explanation. Poor Computer Skills Summary : The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In this role you will be assigned to members based on an alpha split and then review clinical information provided by facilities to determine medical necessity when our members admit. You will also be involved with discharge planning and transfers as needed for higher levels of care or out of network admissions. Seniority level Mid-Senior level Employment type Contract Job function Health Care Provider Industries Hospitals and Health Care #J-18808-Ljbffr