Contract/Travel RN – Utilization Review (Arcata, CA)

Ref #: M-RN-294094

Location: Arcata, CA
Type: Contract/Travel
Start: ASAP
Schedule: Days, 8:00 a.m.–4:30 p.m.
Hours: 36 hours/week
Rate: $1,674 / 36 hours

Requirements:

• Active Registered Nurse (RN) license
• Graduate of an accredited nursing program; BSN preferred
• Prior utilization review or case management experience preferred
• Knowledge of payer guidelines and medical necessity criteria
• Strong analytical skills and accurate clinical documentation
• Excellent verbal and written communication and organizational skills

Key Responsibilities:

• Review patient records to determine medical necessity and appropriate level of care
• Ensure documentation and decisions comply with payer and regulatory guidelines
• Collaborate with treating providers and case management teams to coordinate care
• Prepare and submit clinical documentation to insurance companies
• Monitor length of stay and resource utilization; identify opportunities for efficient, cost-effective care
• Participate in denial management and appeals processes
• Accurately document review findings and maintain audit-ready records