Remote Utilization Review RN RURR 26-06086

Location: Santa Rosa CA
Assignment Duration: 13 Weeks
Schedule: Day Shift 5x8 Hours (8:00 AM 4:30 PM)

• Pay Rate: $40$45/hr based on experience

We are seeking an experienced Remote Utilization Review Registered Nurse (RN) to support healthcare operations by ensuring the appropriate use of medical services and resources. The ideal candidate will have strong knowledge of medical necessity criteria payer guidelines and utilization review processes while working collaboratively with interdisciplinary healthcare teams.

• Perform utilization review activities to ensure appropriate and cost-effective use of healthcare resources
• Review patient medical records for medical necessity and compliance with payer requirements
• Collaborate with physicians case managers and interdisciplinary healthcare teams
• Submit track and monitor authorizations approvals and denials
• Maintain accurate timely and compliant documentation
• Ensure adherence to healthcare regulations and payer guidelines
• Communicate effectively with providers and healthcare staff regarding review outcomes
• Support quality improvement initiatives related to utilization management

• Active Registered Nurse (RN) License
• Recent Utilization Review experience preferred
• Strong understanding of payer guidelines and medical necessity criteria
• Excellent communication critical thinking and organizational skills
• Ability to work independently in a remote environment
• Strong documentation and computer skills
• Ability to manage multiple tasks in a fast-paced healthcare setting

For more details reach at or Call / Text at .

About Navitas Healthcare LLC: It is a certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.