Utilization Management Registered Nurse

Valley Children's HospitalMadera, California

$57 - $82 / hour

Apply with Sonara

Automate your job search with Sonara.

Submit 10x as many applications with less effort than one manual application.¹

Reclaim your time by letting our AI handle the grunt work of job searching.

We continuously scan millions of openings to find your top matches.

Overview

Schedule

Full-time

Education

Nursing (RN, LPN)

Career level

Senior-level

Remote

On-site

Compensation

$57-$82/hour

Job Description

Job Summary:

The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions including but not limited to daily screening of patient admission relative to specified criteria, active involvement in denial management, acting as a resource to staff regarding clinical criteria, communication with payors to address concerns and other duties as assigned. The Utilization Management Nurse will work collaboratively with the Utilization Nurse Program Coordinator to ensure compliance with regulatory, organizational and department requirements. The Utilization Review Nurse will receive direction from the Utilization Review Program Coordinator for daily and long term tasks and projects.

Qualifications:

Education

Associates Degree Nursing (required)
Bachelors Degree Nursing or related field (preferred)

Licenses and Certifications

RN - Registered Nurse License - CA-BRN - California Board of Registered Nursing (required)

Work Experience

Minimum three (3) years Full time equivalent RN experience in an acute care hospital. (required)
Pediatric experience and experience in Case Management and/or Utilization Review. (preferred)

Skills and Abilities

Knowledge of UM regulations.Knowledge of private and public payer reimbursement practices and procedures.Excellent organizational and communication skills and ability to work with a variety of health care professionals.Ability to work independently.
Computer Skills Proficiency with word processing, spreadsheets and database software.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Compensation Range:

$57.29 - $81.72

Workshift:

Day (United States of America)

Position Exempt:

FTE %:

Scheduled Weekly Hours:

Daily Hours:

Have Questions?

Call Recruitment Services at 559-353-7071 or email us at recruiting@valleychildrens.orgDisclaimer: Final compensation will be dependent upon skills and experience.

Automate your job search with Sonara.

Submit 10x as many applications with less effort than one manual application.

Apply with Sonara Apply manually

FAQs About Utilization Management Registered Nurse Jobs at Valley Children's Hospital

What is the work location for this position at Valley Children's Hospital?

This job at Valley Children's Hospital is located in Madera, California, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.

What pay range can candidates expect for this role at Valley Children's Hospital?

Candidates can expect a pay range of $57.29–$81.72 per hour for this role.

What employment applies to this position at Valley Children's Hospital?

Valley Children's Hospital lists this role as a Full-time position.

What experience level is required for this role at Valley Children's Hospital?

Valley Children's Hospital is looking for a candidate with "Senior-level" experience level.

What education level is required for this job?

The education requirement for this position is Nursing (RN, LPN). Candidates with relevant qualifications or equivalent experience may also be considered.

What is the process to apply for this position at Valley Children's Hospital?

You can apply for this role at Valley Children's Hospital either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.