Utilization Review Nurse Job at Akkodis, California, MO

  • Akkodis
  • California, MO

Job Description

Direct message the job poster from Akkodis

Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare space.

Location: Remote (must be based in California)

Employment type: 3.5 month contract

Pay: $55/hr

The Concurrent Review Nurse conducts concurrent reviews of inpatient activities. This role is responsible for ensuring that member care is provided at the most appropriate level, for the appropriate duration, and in compliance with regulatory and contractual requirements. The work is varied and complex, requiring moderate discretion and independent judgment.

Essential Functions:

  • Confirm care plans with healthcare providers.
  • Identify care issues and collaborate with providers to resolve them; escalate when necessary.
  • Make timely and appropriate recommendations regarding transfers, level of care determinations, and discharge planning.
  • Escalate non-standard requests to the Medical Director for review; authorize or deny services as directed.
  • Research and resolve adjudication issues promptly and accurately.
  • Document all activities in the appropriate systems according to organizational standards.
  • Track and compile data as required; produce and submit routine reports.

Qualifications:

Education and Experience

Required:

  • Graduate of an accredited nursing program.
  • Minimum of three (3) years of clinical experience as a Registered Nurse in a hospital or clinic setting.

Preferred:

  • Experience in case management, utilization management, or discharge planning.
  • Experience working in a managed care environment.
  • Experience working with Medi-Cal and/or Medicare populations.

Licensure and Certifications

  • Unrestricted Registered Nurse license in the State of California.

Knowledge, Skills, and Abilities:

  • Strong clinical judgment within the scope of RN practice in California.
  • Ability to interpret and apply complex clinical and regulatory guidelines.
  • Detail-oriented with a focus on accuracy and completeness.
  • Demonstrated ability to manage a varied workload efficiently.
  • Proficient in problem-solving, assessment, and analytical thinking.
  • Basic negotiation and conflict-resolution skills.
  • Effective interpersonal and communication skills, both written and verbal.
  • Strong organizational and time-management skills; able to prioritize and meet deadlines.
  • Customer service-oriented with a commitment to excellence.
  • Proficiency in Microsoft Word and Excel.
  • Ability to navigate and document in multiple software systems and databases.
  • Ability to handle confidential information with discretion.

Equal Opportunity Employer/Veterans/Disabled

Benefit offerings include medical, dental, vision, term life insurance, short-term disability insurance, additional voluntary benefits, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State or local law; and Holiday pay upon meeting eligibility criteria. Disclaimer: These benefit offerings do not apply to client-recruited jobs and jobs which are direct hire to a client

To read our Candidate Privacy Information Statement, which explains how we will use your information, please visit

The Company will consider qualified applicants with arrest and conviction records.

Seniority level
  • Seniority level
    Associate
Employment type
  • Employment type
    Full-time
Job function
  • Job function
    Health Care Provider
  • Industries
    Hospitals and Health Care

Referrals increase your chances of interviewing at Akkodis by 2x

Get notified about new Utilization Review Nurse jobs in California, United States .

RN Disease Management /Case Manager CA REMOTE

California, United States $105,000.00-$140,000.00 2 days ago

Outpatient Registered Nurse - RN - Dialysis

California, United States $48.00-$50.00 1 day ago

Remote RN Case Manager - California Residents ONLY

California City, CA $43.00-$47.00 3 months ago

Field Nurse Consultant Workers' Compensation
Registered Nurse (RN) Med-Tele, Full time, 7pm - 7am
Licensed Vocational Nurse, Out-Patient Case Manager
Licensed Vocational Nurse, Out-Patient Case Manager
Travel Pediatric ICU Registered Nurse - $840 per week
Registered Nurse (RN) Med-Tele, Full time, 7am - 7pm
Licensed Vocational Nurse, Out-Patient Case Manager
UM LVN Delegation Oversight Nurse Remote based in CA
Integrated Transitional Care Nurse, RN 24-00168
UM LVN Delegation Oversight Nurse Remote based in CA
Registered Nurse (RN) Med Surg Tele Stroke (3W) Full Time Days

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.

#J-18808-Ljbffr

Job Tags

Full time, Contract work, Temporary work, Local area, Remote work

Similar Jobs

Berns Landscaping Services

Client Service & Sales Coordinator Job at Berns Landscaping Services

 ...CLIENT SERVICE & SALES COORDINATOR POSITION TYPE: FULL TIME TARGET PAY: $26$29/hour, based on experience and fit POSITION SUMMARY Berns Landscaping Services, Inc. is seeking a strong, experienced Client Service & Sales Coordinator who is organized, professional... 

Circle Logistics

Class A CDL A Flatbed Owner Operator Truck Drivers- Consistent Round Trip Loads Job Job at Circle Logistics

Class A CDL A Flatbed Owner Operator Truck Drivers- Consistent Round Trip Loads JobCDL A Flatbed Owner Operators- Consistent Round Trip Loads- Primary delivery areas to Midwest, East Coast and Southern regions, (No NYC)- Avgs $1.80/ mile, ROUND TRIP ALL MILES, after... 

BJC Healthcare

Physical Therapist Job at BJC Healthcare

 ...Weekend Rotation No on call Community travel within IL BJC Service Areas - Alton &...  ...and instruction/supervision of physical therapy practice. Responsibilities...  ...Certifications Valid Driver's License Physical Therapist License Benefits and Legal... 

Palmetto Bluff

Pool Attendant Job at Palmetto Bluff

 ...Pool & Fitness Center Attendant Palmetto Bluff is nestled along the May River in the Lowcountry of South Carolina between Hilton Head Island and Savannah. As an award winning 20,000 acre development, the development encompasses a private member's only club which includes... 

BASE (Bay Area Social Empowerment)

Fundraising Coordinator Job at BASE (Bay Area Social Empowerment)

 ...Join our team as a Fundraising Coordinator and help bring our mission to life. Youll connect with donors, support community events, and help create meaningful opportunities for people to give. Your efforts will directly strengthen programs that make a difference every...