RN - Utilization Management

Fairfield, CA 94534

Posted: 01/07/2025 Employment Type: Remote Profession: RN Job Number: 310679 Pay Rate: $2,461 - $2,734 Specialty: Utilization Review

Job Description

Registered Nurse - Utilization Management (Remote, California Nursing Jobs) Registered Nurse - Utilization Management (Remote, California)
Join our dynamic Utilization Management team as a Registered Nurse (RN) working remotely from anywhere in California. This role is crucial in ensuring high-quality, cost-effective patient care through effective utilization management. The position requires initial onsite training in Redding, Northern California, for 2-3 weeks, followed by remote work. This is an exciting opportunity to make a significant impact on patient care and outcomes.
Job Details
  • Employment Type: Remote
  • Hours Per Week: 40
  • Shift: 8-hour days, Monday to Friday, with one weekend per month required
  • Duration: 26 weeks
  • Start Date: February 24, 2025
  • Estimated Weekly Salary: $2830 - $3040
Job Requirements
  • Current California RN license
  • 2-3 years of nursing experience, including at least 1 year in managed care or utilization management
  • Strong knowledge of nursing requirements in a clinical setting
  • Familiarity with utilization management programs and protocols
  • Excellent written and verbal communication skills
  • Ability to work independently in a fast-paced environment
  • Must be camera ready for interviews
Responsibilities
  • Conduct retrospective claims reviews and provide summaries to the Team Manager
  • Evaluate appropriateness of care using established guidelines and protocols
  • Coordinate interventions to facilitate high-quality, cost-effective care
  • Document and maintain patient-specific utilization management records
  • Participate in continuous process improvement initiatives
  • Communicate effectively with other departments to resolve authorization issues

Located in Fairfield, CA, this role offers the opportunity to work remotely while enjoying the vibrant community and beautiful surroundings of Northern California. Fairfield is known for its scenic landscapes, wineries, and proximity to both San Francisco and Sacramento, providing a perfect balance of work and leisure. Apply now to join our healthcare team today!
Benefits
401K with Matching, Healthcare, Dental and Vision
About GHR
With over 30 years of healthcare staffing experience, GHR Healthcare is your trusted partner in finding the perfect contract or permanent role in the healthcare industry. Our specialized teams have placed thousands of healthcare professionals nationwide. You will have a dedicated recruiter, providing access to new opportunities and guidance every step of the way. Whatever your career goals, GHR Healthcare is here to support you and find your perfect fit. Get to know us:www.ghrhealthcare.com
Equal Opportunity
We are an equal-opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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About Fairfield, CA

Ready to take your career to the next level? Explore our job opportunities in the vibrant area surrounding Fairfield, California! Nestled in the heart of Solano County, Fairfield offers a perfect blend of opportunity and charm. With its close proximity to renowned wineries in Napa Valley, scenic outdoor adventures at the nearby Suisun Marsh, and cultural gems like the Fairfield Center for Creative Arts, there's something for everyone here. Whether you're drawn to the historic charm of the Jelly Belly Factory, the exciting events at the Travis Air Force Base, or the thriving dining scene featuring fresh local produce, this region has it all. Join us in Fairfield and discover a career path as unique and diverse as the area itself. Apply now and unlock your potential!