Rn Central Utilization Review Nurse

3 weeks ago


Temecula, United States Southwest Healthcare System Full time

**Responsibilities**:
**Join the Southwest Healthcare Team**

**About Us**:
Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care/outpatient locations here to serve the Southern California community. With over 6,000 passionate providers and healthcare employees, our shared goal is to provide convenient access to a wide range of healthcare services in a way that benefits you, your family, and the entire community.

**Job Summary**:
The Southwest Healthcare Regional office in Temecula, CA is seeking **Two (2) Full-Time RN Central Utilization Review Nurses** who will be responsible for carrying out utilization management functions by planning, coordinating, and managing patient needs during hospitalization and throughout the continuum of care. Duties include but not limited to:

- Conducts admission and continued stay reviews per guidelines to ensure medical necessity of level of care and hospitalization for multiple entities.
- Reviews medical record for presence of accurate placement orders reconciles variances with patient providers.
- Collaborates with Patient Access team to ensure correct payer source for hospitalization and communication.
- Ensures compliance of utilization review practices as required by payers, external regulatory agencies, and organization.
- Hybrid schedule may be considered after 90 days of employment.
- Must be available to work weekends and holidays.

Qualifications:
**Experience/Training/Experience**:

- Associates degree in Nursing or Graduate of a Vocational Nursing school required.
- Two (2) years of clinical experience in an acute care hospital setting with (1) year in an inpatient or outpatient case management setting required.

**Certifications/Licenses**:

- Current license as a RN in the State of California required.

**Other Skills and Abilities**:

- Demonstrates knowledge and ensures compliance with the Nurse Practice Act, The Joint Commission and Title 22 standards and guidelines.
- Demonstrates compliance with hospital policies and procedures at all times.
- Demonstrates strong leadership, organization, communication and interpersonal skills.
- Demonstrates ability to relate to clinical personnel and medical staff, as well as ability to interact well with the public.
- Capable of resolving escalated issues arising from operations and requiring coordination with other
- Knowledgeable in Interqual guidelines.

**Benefit Highlights**:

- Challenging and rewarding work environment.
- Competitive Compensation & Generous Paid Time Off.
- Excellent Medical, Dental, Vision and Prescription Drug Plans.
- 401(K) with company match and discounted stock plan.
- SoFi Student Loan Refinancing Program.
- Tuition, CEU, Certification, Licenses Reimbursement program.
- Career development opportunities within UHS and its 300+ Subsidiaries

Southwest Healthcare is owned and operated by subsidiaries of Universal Health Services, Inc. (UHS), a King of Prussia, PA-based company, that is one of the largest healthcare management companies in the nation.

**EEO Statement**:
**Notice**:
**Salary**: Starting from $48.33 to $70.08 an hour


  • RN Case Manager

    2 weeks ago


    Temecula, United States Integrated Resources, Inc Full time

    Job Title: RN Case Manager Location: Temecula, CA Duration: 3 Months + possible extension Shift: Mon - Fri Pay rate: $50/hr.- w2 – $60/hr.- w2. Job Description: · Case management RN / Utilization Review experience required in Inpatient Hospital. · Unit: 87510 - Utilization Review · Desired...

  • Registered Nurse

    5 days ago


    Temecula, United States Aveanna Healthcare Full time

    Position OverviewRegistered Nurse (RN) is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.Pay Rate: $27-32/HREssential Job Functions• Responsible for the delivery...

  • Registered Nurse

    5 days ago


    Temecula, United States Aveanna Healthcare Full time

    Position OverviewRegistered Nurse (RN) is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.Pay Rate: $27-32/HREssential Job Functions• Responsible for the delivery...

  • Registered Nurse

    2 days ago


    Temecula, United States Aveanna Healthcare Full time

    Position OverviewRegistered Nurse (RN) is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.Pay Rate: $27-32/HREssential Job Functions• Responsible for the delivery...

  • Travel Nurse

    3 days ago


    Temecula, United States Bluepipes Remote Work Freelance Full time

    Greenstaff Medical US is seeking an experienced Cardiovascular Operating Room Registered Nurse for an exciting Travel Nursing job in Temecula, CA. Shift: 4x10 hr days Start Date: ASAP Duration: 13 weeks Pay: $3360 / Week About Greenstaff Medical US:At Greenstaff Medical, we pride ourselves on being at the forefront of healthcare staffing solutions, with an...

  • RN Case Manager

    5 days ago


    Temecula, United States Aveanna Healthcare Full time

    RN Case Manager - Clinical Supervisor  Aveanna Healthcare is one of the nation’s largest home health care companies in the United States and growing! We are adding a RN Case Manager to join our clinical team in Temecula, CA. This position provides the opportunity to help develop and provide professional guidance to our field staff, as well as,...

  • RN Case Manager

    4 days ago


    Temecula, United States Aveanna Healthcare Full time

    RN Case Manager - Clinical Supervisor  Aveanna Healthcare is one of the nation’s largest home health care companies in the United States and growing! We are adding a RN Case Manager to join our clinical team in Temecula, CA. This position provides the opportunity to help develop and provide professional guidance to our field staff, as well as,...

  • RN Case Manager

    7 hours ago


    Temecula, United States Aveanna Healthcare Full time

    RN Case Manager - Clinical Supervisor  Aveanna Healthcare is one of the nation’s largest home health care companies in the United States and growing! We are adding a RN Case Manager to join our clinical team in Temecula, CA. This position provides the opportunity to help develop and provide professional guidance to our field staff, as well as,...

  • Travel Nurse RN

    5 days ago


    Temecula, United States TRS Healthcare Full time

    Job DescriptionTRS Healthcare is seeking a travel nurse RN Interventional Radiology for a travel nursing job in Temecula, California.Job Description & RequirementsSpecialty: Interventional RadiologyDiscipline: RNStart Date: ASAPDuration: 5 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelTRS Healthcare Job ID #1140156. Pay package is based on...

  • Travel Nurse RN

    2 days ago


    Temecula, United States TRS Healthcare Full time

    TRS Healthcare is seeking a travel nurse RN Interventional Radiology for a travel nursing job in Temecula, California.Job Description & RequirementsSpecialty: Interventional RadiologyDiscipline: RNStart Date: ASAPDuration: 5 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelTRS Healthcare Job ID #1140156. Pay package is based on 8 hour shifts...


  • Temecula, CA, United States Aveanna Healthcare Full time

    Registered Nurse (RN) is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times. Responsible for the delivery and coordination of quality patient care in compliance with...

  • Travel Nurse RN

    3 days ago


    Temecula, United States OneStaff Medical Full time

    OneStaff Medical is seeking a travel nurse RN Case Management for a travel nursing job in Temecula, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: ASAPDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelCase Management Nurses coordinate long-term care for their patients. Their goal is to...


  • TEMECULA, United States Pacific West Development Full time

    JOB DESCRIPTION TITLE: Superintendent REPORTS TO: Project Manager DIVISION: Southern California DEPARTMENT: Construction JOB DUTIES/RESPONSIBILITIES: Preferable if candidate has apartment experience The Field Superintendent works closely with the General Superintendent (if applicable), Project Managers and Purchasing Department throughout...

  • Travel Nurse RN

    5 days ago


    Temecula, United States Supplemental Health Care Full time

    Supplemental Health Care is seeking a travel nurse RN Case Management for a travel nursing job in Temecula, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: ASAPDuration: 13 weeksEmployment Type: TravelJob Description:Supplemental Health Care is working with a hospital in Temecula, California to hire Case...

  • New Grad RN

    3 days ago


    Temecula, United States BFF Medical Wellness Clinic Full time

    Job DescriptionJob DescriptionWe seek a skilled and motivated Registered Nurse (RN) to join our healthcare team, specializing in IV infusion, blood drawing, and aesthetic procedures such as microneedling and Botox. In this role, you will provide high-quality patient care and support to our medical staff by performing various clinical and administrative...

  • New Grad Rn

    4 days ago


    Temecula, United States BFF Medical Wellness Clinic Full time

    We seek a skilled and motivated Registered Nurse (RN) to join our healthcare team, specializing in IV infusion, blood drawing, and aesthetic procedures such as microneedling and Botox. In this role, you will provide high-quality patient care and support to our medical staff by performing various clinical and administrative tasks. We are willing to teach new...

  • Registered Nurse RN

    4 days ago


    Temecula, California, United States UHS Full time

    Responsibilities About Temecula Valley Hospital Temecula Valley Hospital (TVH), part of Southwest Healthcare, brings advanced technology, innovative programs, patient-centered and family sensitive care to area residents.The hospital features 140 private patient rooms; emergency care; advanced cardiac and stroke care; orthopedics; general and surgical...

  • Registered Nurse

    4 days ago


    Temecula, CA, United States Aveanna Healthcare Full time

    Position Overview Registered Nurse (RN) is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times. Pay Rate: $27-32/HR Essential Job Functions • Responsible for the...


  • Temecula, United States FlexCare Surgery Full time

    FlexCare Surgery is seeking a travel Surgical Technologist for a travel job in Temecula, California.Job Description & RequirementsSpecialty: Surgical TechnologistDiscipline: Allied Health ProfessionalStart Date: ASAPDuration: 13 weeks40 hours per weekShift: 8 hours, eveningsEmployment Type: TravelFlexCare Surgery Job ID #JOB-01389882. Pay package is based on...


  • Temecula, United States FlexCare Surgery Full time

    Job DescriptionFlexCare Surgery is seeking a travel Surgical Technologist for a travel job in Temecula, California.Job Description & RequirementsSpecialty: Surgical TechnologistDiscipline: Allied Health ProfessionalStart Date: ASAPDuration: 13 weeks40 hours per weekShift: 8 hours, eveningsEmployment Type: TravelFlexCare Surgery Job ID #JOB-01389882. Pay...