Top 34 Utilization review nurse Jobs in Riverside Ca

CA Utilization Review Nurse I
CorVel Corporation —Rancho Cucamonga, CA
- $30.64 - $45.80 an hour
- Full-time
- Remote
- Nursing
- LVN
- RN License
- Health savings account
- Disability insurance
Quick Apply
Registered Nurse - Utilization and Care Transitions
Neighborhood Healthcare —Riverside, CA
- $50.10 - $75.10 an hour
- Monday to Friday
- CPR Certification
- Nursing
- Skilled nursing facility
- Health insurance
- Dental insurance
Quick Apply
Clinical Review Nurse - Prior Authorization
Akido —Chino, CA
- $62,400 - $93,600 a year
- LVN
- RN License
- Mid-level
Quick Apply
Provider Quality Review Nurse, RN
Inland Empire Health Plan —Rancho Cucamonga, CA
- $91,249.60 - $120,910.40 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Word processing
- Disability insurance
- Health insurance
Utilization Specialist PRN
Pacific Grove —Riverside, CA
- $31 - $50 an hour
- PRN
- CPR Certification
- Nursing
- RN License
- Employee assistance program
Utilization Specialist Full-time
Pacific Grove —Riverside, CA
- $31 - $50 an hour
- Full-time
- Acute care
- CPR Certification
- Nursing
- Health savings account
- Paid holidays
Nurse Practitioner
Vista Community Clinic —Lake Elsinore, CA
- $66 - $70 an hour
- Part-time
- CPR Certification
- Nursing
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
COORDINATOR, UM (LVN)
Pomona Valley Hospital Medical Center —Pomona, CA
- $35.95 - $50.59 an hour
- Full-time
- LVN
- Hospital
- Mid-level
Case Manager - FT Days
Riverside Medical Clinic —Riverside, CA
- $44.74 - $64.88 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Case Manager (RN) - Utilization Management
Chino Valley Medical Center —Chino, CA
- $43.25 - $58.21 an hour
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
Case Manager (RN) - Utilization Management
Montclair Hospital Medical Center —Montclair, CA
- $50 an hour
- Day shift
- Acute care
- Nursing
- RN License
- Health insurance
- Dental insurance
10d
Care Manager-RN
Loma Linda University Health —Redlands, CA
- $59.77 - $80.39 an hour
- Full-time
- Spanish
- Nursing
- Microsoft Outlook
Case Manager
Loma Linda University Health —Loma Linda, CA
- $59.18 - $79.60 an hour
- 8 hour shift
- Spanish
- Nursing
- Microsoft Outlook
per diem IVF coordinator
Loma linda fertility and wellness center —San Bernardino, CA
- From $24 an hour
- Part-time
- Background check
- Nursing
- RN License
- 401(k)
Quick Apply
Medical Field Case Manager
Enlyte —Lake Elsinore, CA
- $95,000 - $98,000 a year
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
Case Manager
Ontario Grove Healthcare & Wellness Centre —Ontario, CA
- $30 - $45 an hour
- Part-time
- Mid-level
- Administrative experience
- Bachelor's degree
Quick Apply
Care Manager (Case Management)
Redlands Community Hospital - UTILIZATION MANAGEMENT —Redlands, CA
- $49.98 - $72.47 an hour
- Per diem
- CPR Certification
- Nursing
- RN License
RN Care Coordinator
St Bernardine Medical Center —San Bernardino, CA
- $55.68 - $72.66 an hour
- Full-time
- Acute care
- Nursing
- Surgery
10d
Concurrent Case Management LVN
LSMA Management Inc —San Bernardino, CA
- $35 - $40 an hour
- Full-time
- Nursing
- LVN
- BLS Certification
Concurrent Case Management RN
LSMA Management Inc —San Bernardino, CA
- $85,000 - $100,000 a year
- Full-time
- Nursing
- RN License
- Bachelor of Science

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utilization review nurse jobs near riverside ca

CA Utilization Review Nurse I

CorVel Corporation -
Rancho Cucamonga, CA

Quick Apply

Job Details

Full-time
$30.64 - $45.80 an hour

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance
Opportunities for advancement
Life insurance

Qualifications

Customer communication
Medical coding guidelines

Full Job Description

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
Collects data and analyzes information to make decisions regarding certification or denial of treatment
Documents all work in the appropriate manner
Promotes utilization review services with stakeholders
Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
Additional duties as assigned

KNOWLEDGE & SKILLS:

Must have thorough knowledge of both CPT and ICD coding
Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers
Effective organization skills in a high-volume, fast-paced environment
Strong time management skills with the ability to meet designated deadlines
Excellent written and verbal communication skills
Ability to work both independently and within a team environment
Strong interpersonal skills
Ability to utilize Microsoft Office including Excel spreadsheets
Knowledge of the workers’ compensation claims process preferred
Knowledge of outpatient utilization review preferred

EDUCATION & EXPERIENCE:

Graduate of accredited school of nursing with an associate’s degree, Bachelor of Science degree or Bachelor of Science in Nursing
Current Nursing licensure in the state of operation required; RN is required unless local state regulations permit LVN/LPN
4 or more years of recent clinical experience
Prospective, concurrent, and retrospective utilization review experience preferred
Experience in the clinical areas of OR, ICU, CCU, ER and/or orthopedics preferred

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $30.64 - $45.80 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management (https://www.corvel.com/company/careers/)

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

#LI-Remote

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

utilization review nurse jobs in riverside ca

CA Utilization Review Nurse I

Registered Nurse - Utilization and Care Transitions

Clinical Review Nurse - Prior Authorization

Provider Quality Review Nurse, RN

Utilization Specialist PRN

Utilization Specialist Full-time

Nurse Practitioner

COORDINATOR, UM (LVN)

Case Manager - FT Days

Case Manager (RN) - Utilization Management

Case Manager (RN) - Utilization Management

Care Manager-RN

Case Manager

per diem IVF coordinator

Medical Field Case Manager

Case Manager

Care Manager (Case Management)

RN Care Coordinator

Concurrent Case Management LVN

Concurrent Case Management RN

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