Utilization Review RN
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Utilization Review Nurse to join
their Clinical Review team.
Key Responsibilities
Complete medical necessity and level of care reviews using clinical
judgment and guidelines
Obtain necessary information to assess a member's clinical
condition and apply evidence-based guidelines
Refer members for further care engagement and ensure compliance
with applicable laws and regulations
Required Qualifications
Active, unrestricted RN licensure from the United States or compact
multistate RN license
Associate Degree in Nursing or graduate of an accredited school of
nursing
Ability to obtain additional state licenses as needed
1+ year of utilization review experience in a managed care
setting
2+ years of clinical experience, including at least 1 year in an
acute care setting
Keywords: VirtualVocations, Gardena , Utilization Review RN, Healthcare , Vista, California
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