Concurrent Review Nurse RN - Remote

Overview

The Alliance is seeking a Concurrent Review Nurse RN to join the Utilization Management Department, responsible for reviewing acute in-patient care services and participating in the UM Care Program.

In Short
• Perform concurrent or post-service review of acute in-patient care services.
• Participate in the Utilization Management Care Program.
• Knowledge of Utilization Management and Case Management principles.
• Ability to demonstrate strong critical thinking and problem-solving skills.
• Navigate and evaluate electronic medical records.
• Current unrestricted RN license in California required.
• Associate’s degree in Nursing with relevant experience.
• Hybrid work environment with remote interview process.
• Attendance at quarterly events may be required.
• Compensation based on qualifications and location.
Requirements
• Knowledge of Utilization Management and Case Management principles.
• Understanding of Medi-Cal policies and Title 22 regulations.
• Strong critical thinking and problem-solving skills.
• Experience in an acute care setting.
• Current RN license in California.
• Ability to evaluate healthcare data.
• Excellent communication skills.
• Ability to exercise good judgment in healthcare settings.
• Education in Nursing with relevant experience.
• Ability to work in a hybrid environment.
Benefits
• Medical, Dental, and Vision Plans.
• Ample Paid Time Off.
• 12 Paid Holidays per year.
• 401(a) Retirement Plan.
• 457 Deferred Compensation Plan.
• Robust Health and Wellness Program.
• Onsite EV Charging Stations.

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