State Licensed Utilization Review Nurse
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Utilization Review Nurse, Full-Time
(9a-9p EST), Remote.
Key Responsibilities
Review and evaluate electronic medical records for emergency
department admissions to assess medical necessity
Apply clinical guidelines to ensure proper utilization of
healthcare resources and participate in discussions with emergency
department physicians
Enter clinical review information into the system for insurance
authorization and analyze utilization patterns and trends
Required Qualifications
Current and unrestricted RN license
At least 3 years of clinical experience in an acute care setting,
particularly in emergency room, critical care, or medical/surgical
nursing
At least 2 years of utilization management experience in acute
admission and concurrent reviews
Intermediate experience with InterQual and/or MCG criteria within
the last two years
Proficiency in medical record review in an electronic medical
record (EMR) system
Keywords: VirtualVocations, Alhambra , State Licensed Utilization Review Nurse, Healthcare , Vista, California
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