Clinical Utilization Review Nurse Specialist

7 days ago


Fountain Valley, California, United States UCI Health Full time

Job Title:

Registered Nurse - Case Manager

Job Summary:

We are seeking a highly skilled Registered Nurse to join our team as a Clinical Utilization Review Nurse Specialist. In this role, you will be responsible for collaborating with healthcare providers to ensure patient care is delivered efficiently and effectively.

Key Responsibilities:

  • Review patient cases to determine the appropriateness of hospital admissions, length of stay, and services provided.
  • Analyze patient records to coordinate with medical teams and determine the necessity of treatments.
  • Provide case management services and monitoring of resources to achieve cost-effective healthcare delivery.
  • Maintain up-to-date knowledge of current medical guidelines and insurance policies.
  • Communicate with patients, families, and healthcare teams regarding care plans and potential discharge.
  • Ensure compliance with healthcare regulations and standards.
  • Exhibit strong problem-solving and critical-thinking skills in fast-paced environments.

What We Offer:

A competitive salary of approximately $37,500 per year, depending on experience.

About Us:

UCI Health is a leading healthcare provider dedicated to delivering high-quality patient care. Our team of experienced professionals is passionate about making a difference in the lives of our patients and their families.


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