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Utilization Management Nurse Job
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | San Francisco, CA San Francisco, California |
About this job
Utilization Management Nurse needed for a contract opportunity with Yoh's client located in San Francisco, CA.
Top Skills You Should Possess:
- Experience in utilization review / utilization management
- Health Plan Experience
What You'll Be Doing:
- Conduct utilization reviews at inpatient facilities, including acute care, and/or process authorization requests for various services
- Review authorization requests for out-of-network inpatient facilities
- Provide care coordination of members who are transitioning from one level of care to another
What You Need to Bring to the Table:
- California RN license
- Two (2) plus years clinical nursing experience
- Bilingual in Cantonese preferred, not required
- Experience with utilization management, disease management, and coordination of care within a managed care/health plan environment
- Knowledge of Medicare and Medi-Cal coverage requirements and regulatory guidelines
Bonus Points! Otherwise Known As Preferred Qualifications:
- Bachelor's degree in nursing or a related health services field
What Are You Waiting For? Apply Now!
Recruiter: Annie Gill
Yoh makes finding and applying for jobs simple. Partner with Yoh to find the right opportunities across multiple industries in the US and UK. Find out more !
Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. to contact us if you are an individual with a disability and require accommodation in the application process.
J2W: HC
MONJOB
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Ref: 1039180
SFSF: REN