Open Position: RN - Utilization Review

Estimated Gross Weekly Pay: $2208.20

Opportunity:

Not specified

Job Details:

* Shift hours are 8:00 AM 4:30 PM or 9:00 AM 5:30 PM PST
* Position is 100% remote supporting a centralized Utilization Management team
* Supports three facilities with rotation between all three
* Every third weekend rotation required for the length of the contract
* Must work in Pacific Standard Time
* Minimum 3 years of acute medical Care Manager/Utilization Management experience performing utilization review in a hospital setting (not health plan or medical group) required
* InterQual experience is a hard stop requirement
* Epic charting system experience is required with recent use within the last 6?12 months
* Medicare knowledge is a hard stop requirement
* Experience with HMOs, IPAs, and Medicare regulations regarding specific UM processes such as CC44s, ABNs, HINNs, and MCSNs required
* CA license required
* CA and Medi-Cal experience and knowledge preferred
* Patient ratio experience of 40 patients required
* Serves a variety of service lines and levels of care including inpatient, Extended Hospital Outpatient, and observation
* Treats patient age groups including adolescents, adults, pediatrics, and geriatrics
* Patient diagnoses include a variety of adult and pediatric acute and chronic conditions
* Strict adherence to all CA labor laws regarding lunches and breaks required
* Zero overtime unless approved by leadership prior to end of shift
* Zero working off the clock permitted
* Laptop, keyboard, and mouse will be provided by the facility
* Must commit to working 3 of the 5 holidays: Thanksgiving, Christmas Eve, Christmas Day, New Year's Eve, and New Year's Day
* May be expected to float between sister facilities; refusal to float may result in termination or forfeiture of guaranteed hours

Facility:

This healthcare organization operates a centralized Utilization Management team supporting multiple facilities across various service lines and levels of care, including inpatient, extended hospital outpatient, and observation settings. The facility is committed to delivering high-quality patient care across a broad range of acute and chronic diagnoses for all age groups, while maintaining strict compliance with state labor laws and regulatory standards.

Location:

Remote, CA

This fully remote position allows you to work from the comfort of your home while supporting facilities in California, offering the flexibility to enjoy the diverse lifestyle and vibrant communities the state has to offer. California provides an unmatched combination of stunning landscapes, cultural richness, and year-round mild weather, making it one of the most desirable places to live and work in the country.

Equal Employment Opportunity Statement:

Noor Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic.

Physicial Requirements:

This position requires the ability to perform the essential functions of the role, which may include standing for extended periods, bending, reaching, and lifting up to 50 pounds on an occasional basis, with or without reasonable accommodation. Physicial demands may vary depending on assignment and client-site requirements.