Registered Nurse Utilization Review

Immediate need for a talented Registered Nurse Utilization Review - Onsite-Santa Clara, CA. This is a 03+ months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 26-04902

Pay Range: $75 - $90/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Schedule: 8:00 AM – 4:30 PM
• Open to candidates across the United States willing to work onsite in CA
• 5 days/week including every other weekend (Saturday & Sunday)
• Perform inpatient concurrent and continued stay reviews
• Apply InterQual or MCG criteria for medical necessity and level-of-care decisions
• Collaborate with hospital case managers and interdisciplinary teams
• Participate in discharge planning coordination
• Manage denials, authorizations, and payer communications
• Ensure compliance with CMS and regulatory standards

Key Requirements and Technology Experience: 

• Active California RN License (Required prior to start)
• 2+ years of inpatient acute care case management or utilization review experience
• Experience with InterQual or MCG
• Strong knowledge of Medicare / CMS guidelines
• Acute hospital background required

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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