Top 5 Utilization review nurse Jobs in Salinas, Ca

Registered Nurse
Best Home Health Providers, Inc. —Watsonville, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance

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Utilization Specialist - Full Time
San Jose Behavioral Health —San Jose, CA
LMFT, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required,…
$33 - $50 an hour
4d
Utilization Management and Discharge Planning RN
Santa Clara Family Health Plan —San Jose, CA
The Utilization Management and Discharge Planning Nurse performs clinical review in accordance with applicable regulatory and professional standards for…
$100,968 - $151,451 a year
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Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital - Columbus Vic Village(Grant) —Columbus, OH
Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per…
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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
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Registered Nurse

Best Home Health Providers, Inc. -
Watsonville, CA

Quick Apply

Job Details

Part-time
$110 - $130 a year

Benefits

Mileage reimbursement
Flexible schedule
Bereavement leave
Referral program
Paid sick time

Qualifications

CPR Certification
Home health care assistance
Electronic health records (EHR) management
RN License
BLS Certification
Regulatory compliance
In-home healthcare experience
Driver's License
Computer skills
Home healthcare regulations
Clinical documentation standards
Home health agency experience
Legal compliance

Full Job Description

At Best Home Health Providers Inc., we've gone from treating 10 patients to thousands of patients all throughout the Bay Area and beyond in just 6 years. We've won awards for our high-quality care with patients and continue to grow rapidly. At Best, you and the patients aren't a number.

Our mission is to ensure a smooth transition for patients returning home from medical facilities by offering expert guidance throughout their recovery journey. As a Registered Nurse with Best Home Health Providers, you will play a key part in ensuring the accuracy and quality of clinical documentation, helping our patients receive the right care at the right time. You’ll collaborate closely with clinical staff, contribute to quality improvement initiatives, and help uphold our commitment to regulatory compliance.

We value teamwork, empathy, and a commitment to high-quality service, all aimed at putting patients and their families at ease during their recovery. If you are passionate about making a positive impact in patients' lives and working in a supportive and family-oriented atmosphere, we encourage you to join us in providing exceptional home health care.

Please note that this role is per diem with a rate of $110 - $130 per visit.

Responsibilities

Review OASIS assessments for completeness, appropriateness, and compliance with federal and state regulations.
Ensure accurate ICD-10 coding and sequencing based on each patient’s medical condition and co-morbidities.
Partner with clinical staff to resolve documentation and data integrity issues.
Monitor visit utilization and flag potential financial risks or underutilization to clinical management.
Identify and communicate trends that impact agency outcomes and process measures.
Conduct OASIS inter-rater reliability visits with clinical team members.
Participate in Quality Improvement and Corporate Compliance activities.
Stay current with best practices through ongoing education and professional development.
Perform other duties as required for patient services.

Requirements

Active Californian RN license in good standing.
1–2 years of clinical home health experience.
Working knowledge of OASIS assessments and ICD-10 coding.
Knowledge of federal regulations and state licensure requirements.
Strong communication skills and a keen eye for detail.
Ability to work independently and manage priorities with minimal supervision.
Proficiency with computer systems and electronic health records.
Current CPR certification with AHA.
Valid driver’s license, reliable insured vehicle.

Nice to Have

OASIS certification (COS-C).
OASIS Home Health ICD-10 coding certification.

Benefits

Flexible Schedule
Ability to Convert to Full-Time Based On Performance If Interested
Paid Sick Days
Paid Bereavement Leave
Skills Training & Development
Company Social Events
Mileage Reimbursement for Patient to Patient Visits
Referral Bonus

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utilization review nurse jobs in salinas, ca

Registered Nurse

Utilization Management Reviewer

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