Join Our Team: Inpatient Review Clinician (RN) - California, Night Shift

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.