Utilization Review Nurse

2 days ago


Goleta, California, United States Cottage Health Full time

Job Summary

The Utilization Review Nurse is a key member of the Cottage Health team, responsible for ensuring the highest level of patient care and quality outcomes. This role involves utilization review, utilization management, and quality assurance activities for assigned services/areas/patients within the Cottage Health System.

Key Responsibilities

  • Maintain a working knowledge of regulations and provider contracts governing coverage of inpatient services.
  • Collaborate with medical staff, nursing staff, and other disciplines to support and achieve the goals of the collaborative care process.
  • Develop and maintain interpersonal skills and productive relationships with stakeholders.
  • Consistently demonstrate professionalism and compassion in interactions with patients, families, and colleagues.
  • Contribute to an overall value-oriented experience of stakeholders and persons served in a manner compliant with The Joint Commission, HIPAA, and Title 9 Regulations (DHCS).

Qualifications

  • Minimum education to allow candidate to achieve California RN license.
  • Current California Registered Nurse license in good standing.
  • Preferred: Bachelor's Degree in Nursing (BSN), Certification in Case Management.

About Us

Cottage Health is a leading acute care hospital system, committed to serving the central coast communities with excellence, integrity, and compassion. Our mission is to put patients first and provide a superior patient care experience.



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