Utilization Management Nurse
$74.16 - $107.75 per hourUCLA Health
Utilization Review Nurse
Work Location: Los Angeles, CA, USA
Onsite or Remote Fully On-Site Work Schedule Monday-Friday 8am-4:30pm
Salary Range: $74.16 - $107.75 Hourly
Employment Type 4 - Staff: Limited Duration 6 months
Job # 30315
Primary Duties And Responsibilities
The Utilization Review Nurse is part of the Utilization Management Department at the Resnick Neuropsychiatric Hospital, supporting inpatient, partial hospital, and intensive outpatient programs. Performs clinical reviews with third party payors in order to obtain authorization, supporting the revenue cycle. Acts as a liaison between third party payors and the treatment team. Collaborates with financial counseling and the revenue cycle team. Follows up on payor denials and initiates appeals. Provides consultation to treatment team members regarding payor requirements. Completes required documentation within the electronic health record. Adheres to current organizational performance improvement priorities and takes action to improve practices and policies.
Job Qualifications
- BSN or MSN, required
- 5 years of psychiatric nursing care experience required.
- Current valid CA RN license, required
- BLS from the ARC or AHA, required.
- Prior case management experience, highly desired
- Proficient in Microsoft Office
Vacancy posted 4 days ago
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