Rn - Quality Assurance/utilization Review - Business Development - Full Time 8hr
Emanate Health Foothill Presbyterian Hospital
Covina, CA, US
Base: $52.03 - $80.64; bonus/equity: not specified...
Utilization management experience
Medical necessity review
Clinical judgment application
Everyone at Emanate Health plays a vital role in the care we deliver
Job Summary
Everyone at Emanate Health plays a vital role in the care we deliver.
The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying clinical acumen and the appropriate application of policies and guidelines to urgent and standard reviews.
Emanate Health was named the #1 ranked health care system in the United States on Glassdoor's list of Best Places to Work in 2021.
Matching Summary
Everyone at Emanate Health plays a vital role in the care we deliver.
Salary
Base: $52.03 - $80.64; Bonus/Equity: Not specified; Benefits: Not specified
Skills & Requirements
Must-have
Utilization management experience
Medical necessity review
Clinical judgment application
Customer service skills
Computer proficiency
Nice-to-have
Team collaboration
Support medical claims review
Apply clinical guidelines
Key Requirements
Minimum three years utilization management experience