Travel Utilization Review RN

About This Role

This role is for a Registered Nurse specializing in Utilization Review, focusing on ensuring medical necessity and coordinating care for patients in an outpatient clinic setting in Torrance, CA.

Requirements

• 1 year of experience
• Acute Hospital skills
• Ambulatory skills
• ICU skills
• MS skills
• Admission Criteria
• Care coordination
• Concurrent Review
• Continued Stay Reviews
• Determine Medical Necessity per Evidence-Based Guidelines
• Disease management
• Plan of Care
• Utilize InterQual Criteria
• CPT (Current Procedural Terminology) coding and billing
• Medical Necessity
• CMS: Centers for Medicare and Medicaid Services
• Department of Health
• DRG (Diagnosis Related Groups)
• HIPAA guidelines (Health Insurance Portability and Accountability Act)
• The Joint Commission/ Core Measure/National Safety Goals

Qualifications

• 1 Year of experience

Skills

* Required skills

Benefits