Utilization Review Nurse
- UCLA Health and David Geffen School of Medicine
- Los Angeles, CA, USA
Job Description
The Utilization Review Nurse is part of the Utilization Management Department at the Resnick Neuropsychiatric Hospital, supporting inpatient, partial hospital, and intensive outpatient programs. Performs clinical reviews with third party payors in order to obtain authorization, supporting the revenue cycle. Acts as a liaison between third party payors and the treatment team. Collaborates with financial counseling and the revenue cycle team. Follows up on payor denials and initiates appeals. Provides consultation to treatment team members regarding payor requirements. Completes required documentation within the electronic health record. Adheres to current organizational performance improvement priorities and takes action to improve practices and policies.
Salary Range: $74.16- $107.75
*This position may covert to career*
- BSN or MSN, required
- 5 years of psychiatric nursing care experience required.
- Current valid CA RN license, required
- BLS from the ARC or AHA, required.
- Prior case management experience, highly desired
- Proficient in Microsoft Office
A PASSION FOR ADVANCING NURSING EXCELLENCE
At UCLA Health and the David Geffen School of Nursing, you’ll be inspired and empowered to reach your fullest potential in your nursing career. Through close collaboration with other outstanding clinicians in our inclusive and engaging working environment, you can play a critical role in the delivery of our world-class care. Our Center for Nursing Excellence, state-of-the-art technology, shared governance, recognition programs, and more, will equip you to go further in your nursing practice than you thought possible. It’s no wonder we’ve achieved Magnet® status multiple times in multiple locations.
If you’re ready to live out your passion and advance your nursing career, we invite you to explore opportunities throughout our award-winning system, including:
● Ronald Reagan UCLA Medical Center
● UCLA Medical Center, Santa Monica
● Resnick Neuropsychiatric Hospital at UCLA
● UCLA Mattel Children’s Hospital
● More than 280 community-based clinics throughout Southern California
No matter where you serve with UCLA Health, the cultural, recreational, and lifestyle advantages of our Southern California locations will elevate your standard of living.