RN Utilization Review (Days) — Contract in Arcata, CA | $2,052/36-hr, Remote-friendly, Needs UR/Case Mgmt Skills

Ref #: M-RN-293973

Join a contract utilization review team in Arcata, CA. This day-shift role (8:00 a.m.–4:30 p.m.) begins ASAP and is paid $2,052 per 36-hour week.

Key details:

• Location: Arcata, CA
• Assignment: Contract/Travel
• Shift: Days, 8:00 a.m.–4:30 p.m.
• Pay: $2,052 / 36 hours
• Start: ASAP

Minimum qualifications:

• Active RN license in good standing
• Graduate of an accredited nursing program (BSN preferred)
• Prior utilization review or case management experience preferred
• Familiarity with payer guidelines and medical necessity criteria
• Strong analytical, documentation, communication, and organizational skills

Core responsibilities:

• Review clinical records to evaluate medical necessity and appropriate level of care
• Ensure adherence to payer and regulatory requirements
• Collaborate with providers and case management teams to coordinate care
• Prepare and submit clinical documentation to insurance carriers
• Monitor length of stay and resource utilization, identifying opportunities for cost-effective care
• Participate in denial management and appeals
• Accurately document review findings and decisions

If you meet the qualifications and are ready to start quickly, this role offers an impactful opportunity to apply clinical judgment and utilization expertise in a collaborative setting.