Utilization Management Nurse
Company: VirtualVocations
Location: Vista
Posted on: May 5, 2025
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Job Description:
A company is looking for a Pre-Certification/Utilization
Management Nurse.
Key Responsibilities:
Conduct utilization and quality management activities in accordance
with policies and procedures
Perform clinical reviews and authorize services based on medical
necessity criteria
Collaborate with Intake Coordinators and Case Managers to ensure
timely care coordination
Qualifications:
Current, unrestricted RN license in a state or territory of the
United States
2-3 years of experience in utilization review, quality assurance,
or related fields preferred
Two years of hospital-based nursing experience required
HCQM, HRM, or similar certification preferred
Working knowledge of utilization management or case management
preferred
Keywords: VirtualVocations, Montebello , Utilization Management Nurse, Executive , Vista, California
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