Job Overview:
We are seeking a highly skilled and compassionate Inpatient Review Clinician (RN) to join our team in California. As an Inpatient Review Clinician, you will play a critical role in assessing inpatient services, ensuring optimum outcomes, and promoting cost-effective care for our members. This is a remote opportunity with a permanent night shift schedule, working 12 hours, 3 days a week, from 7:30 PM to 8:30 AM Pacific Time.
Key Responsibilities:
- Assess inpatient services to ensure medically appropriate and cost-effective care
- Analyze clinical service requests against evidence-based guidelines
- Conduct inpatient reviews to determine financial responsibility and ensure compliance with regulations
- Collaborate with multidisciplinary teams to promote our care model and ensure seamless care coordination
- Process requests within required timelines and refer cases to Medical Directors as needed
Requirements:
- Graduate from an Accredited School of Nursing
- 3+ years of hospital acute care/medical experience
- Active, unrestricted State Registered Nursing (RN) license in good standing, with a valid California RN license
- Valid driver's license with a good driving record and reliable transportation
Preferred Qualifications:
- Bachelor's Degree in Nursing
- Recent hospital experience in ICU, Medical, or ER unit
- Experience with InterQual or MCG guidelines
- Utilization Management Certification (CPHM)
What We Offer:
- Competitive salary range: $30.37 - $59.21 per hour
- Comprehensive benefits package
- Opportunities for professional growth and development
- A dynamic and supportive work environment
How to Apply:
If you are a motivated and compassionate RN looking to make a difference in the lives of our members, we encourage you to apply. Please submit your application through our website. We are an Equal Opportunity Employer (EOE) M/F/D/V and welcome applications from diverse candidates.
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