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Utilization Review Nurse (RN) (2745)

Quality Assurance Nurse | Woodland Hills, CA | Contract

Job Description
Utilization Review Nurse (RN)
Work Location: Woodland Hills, CA

Job Summary/Description
We have an exciting opportunity available for a Utilization Review Nurse (RN) to come work with our client located in Woodland Hills, CA. As the UR Nurse, you’ll work behind the scenes to maximize cost efficiency and quality of various health care services. Through reviews and audits, you’ll ensure that patients receive care they need without burdening health care systems with unnecessary procedures, ineffective treatments and/or overlong hospital stays. It may also be your duty to educate and inform patients on the benefits and limitations of their specific health care coverage. So, if you’re ready to provide patients with information that they need, then apply now to begin the recruiting process today!

Job Duties/Responsibilities/Functions (including but not limited to)
• Investigates assigned cases - obtains and organizes/labels clinical documents; researches internal databases and outside sources as needed; prepares a written summary of medical and related records relevant to the PQI; determines appropriate review level based on departmental protocols and case findings; records comprehensive rationale for case closure or escalation to next level review.
• Prepares cases on-line using department database.
• Presents case review summaries/finding to Medical Director at weekly Case Review Meetings as appropriate.
• Prepares and follows case for subsequent multi-level reviews as needed.

Minimum Qualifications
• Active Registered Nurse License (RN)
• 3 years Nursing Experience
• Quality Management Experience

About InGenesis
InGenesis is dedicated to placing people in positions that preserve life, improve lives and inspire others. This does not happen without passionate people, skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. Founded in 1998, InGenesis manages thousands of employees, including pioneering healthcare, science, technology and pharma professionals. The workforce solutions company includes almost half of the Fortune 500 in its nearly 300 clients. It is recognized as one of the largest healthcare staffing firms, and InGenesis is the largest minority/women owned healthcare staffing firm in North America.

EEOC Statement
We support a diverse workforce and is an Equal Opportunity Employer who does not discriminate against employees and applicants for employment on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, genetic information, disability, veteran status, or other classification protected by law.