Registered Nurse Utilization Review - RNUR26-06086

Registered Nurse

• Utilization Review

• RNUR26-06086

  NavitasPartners
• 4.

0 Vallejo, CA Job Details Full-time From $40 an hour 9 hours ago Qualifications RN License Pre-authorization review for utilization management

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 experience preferred Experience in Utilization Review, Case Management, or similar clinical coordination role preferred Strong understanding of medical necessity criteria and payer guidelines Knowledge of insurance authorization and review processes Strong documentation, analytical, and communication skills Ability to work independently in a remote setting Experience with EMR systems preferred (Epic preferred) Job Responsibilities Perform utilization review for inpatient and outpatient services Evaluate medical records for appropriate level of care and medical necessity Process prior authorizations and continued stay reviews Collaborate with physicians, case managers, and insurance payers Document review decisions accurately in EMR systems Identify cases requiring escalation to clinical reviewers or medical directors Support discharge planning and care coordination when needed Ensure compliance with regulatory, payer, and facility guidelines Maintain productivity and quality standards in a remote environment 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.