Registered Nurse Utilization Review - RNUR26-06087

Registered Nurse

• Utilization Review

• RNUR26-06087

  NavitasPartners
• 4.

0 Oakland, CA Job Details Full-time From $40 an hour 1 day ago Qualifications RN License Clinical documentation standards

Full Job Description Job Title:

Registered Nurse•

Utilization Review Location:

Santa Rosa, CA Shift Details:

Day Shift | 5x8 Hours | 08:00 AM

• 04:30

PM Contract Duration:

13

Weeks Orientation:

40 Hours (Non-Billable) Required Qualifications Active Registered Nurse (RN) License required Minimum 1-2 years acute care nursing experience preferred Experience in Utilization Review, Case Management, or similar role preferred Strong understanding of medical necessity, payer guidelines, and clinical documentation Knowledge of insurance authorization processes preferred Strong analytical, communication, and decision-making skills Ability to work independently in a remote environment Proficiency with EMR systems preferred (Epic experience a plus) Job Responsibilities Perform utilization review of inpatient and outpatient cases Evaluate medical necessity based on clinical guidelines and payer policies Review patient records and documentation for appropriate level of care Collaborate with physicians, case managers, and insurance providers Process prior authorizations and continued stay reviews Document all review decisions accurately in EMR systems Identify cases requiring further clinical escalation Ensure compliance with regulatory, hospital, and insurance standards Support discharge planning and care coordination as needed Maintain productivity and quality standards in a remote setting For more details contact at About Navitas Healthcare, LLC 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.