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Utilization Management Nurse Reviewer

Company: VirtualVocations
Location: Vista
Posted on: May 20, 2025

Job Description:

A company is looking for a Utilization Management Nurse Reviewer (RN/LPN).
Key Responsibilities

Conduct assessments of medical services to validate appropriateness and necessity using established criteria and guidelines
Examine patient records to verify quality of care and necessity of services provided
Provide clinical expertise and serve as a reference for non-clinical staff

Required Qualifications, Training, and Education

Licensed Practical/Vocational Nurse or Registered Nurse with an active and unrestricted license
Minimum of 2 years clinical nursing experience required
At least 1 year of previous experience in Utilization Management required
Background in medical or clinical practice through education, training, or professional engagement
Proficient with Microsoft tools such as Word, Excel, PowerPoint, and Outlook

Keywords: VirtualVocations, East Los Angeles , Utilization Management Nurse Reviewer, Executive , Vista, California

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