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Hourly Weekend Utilization Review Jobs in California

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity ...

Prime Healthcare

Utilization Review RN

Ontario, CA · On-site

$71K - $104K/yr

At least 3 years of experience in utilization review, referrals, authorizations, denials and appeals. * Current BCLS (AHA) certificate upon hire and maintain current. * Knowledge of MCG Criteria and ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity ...

Prime Healthcare

Utilization Review RN

Ontario, CA · On-site

$71K - $104K/yr

At least 3 years of experience in utilization review, referrals, authorizations, denials and appeals. * Current BCLS (AHA) certificate upon hire and maintain current. * Knowledge of MCG Criteria and ...

CorVel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · On-site

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity ...

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Hourly Weekend Utilization Review information

What is the difference between Hourly Weekend Utilization Review vs Medical Billing Specialist?

AspectHourly Weekend Utilization ReviewMedical Billing Specialist
CredentialsTypically requires healthcare-related certifications, such as RHIT or RHIARequires coding certifications like CPC or CCS
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizations, often during weekendsMedical offices, billing companies, or hospitals, primarily weekdays
Job FocusAssessing patient care and resource utilization during weekendsProcessing insurance claims, coding, and billing

Hourly Weekend Utilization Review involves evaluating patient care and resource use during weekends, often requiring healthcare certifications. In contrast, Medical Billing Specialists focus on coding and billing processes, mainly during weekdays. Both roles are essential in healthcare operations but differ in focus, credentials, and work hours.

What are the most commonly searched types of Weekend Utilization Review jobs in California? The most popular types of Weekend Utilization Review jobs in California are:
What cities in California are hiring for Hourly Weekend Utilization Review jobs? Cities in California with the most Hourly Weekend Utilization Review job openings:
Hourly Weekend Utilization Review jobs near you

Utilization Review Nurse (RN)

Madera Community Hospital

Madera, CA • On-site

Other

Re-posted 22 days ago

Job description

Utilization Review Nurse

Located in the heart of Central California, Madera Community Hospital is a General Acute Care, private, not-for-profit hospital dedicated to improving and maintaining the health and wellness of residents throughout the Central Valley. We are committed to identifying and serving our community's needs with compassion, concern, care and safety for every patient. Madera Community Hospital is a growing acute care facility seeking talented individuals with a drive to provide quality care and dedicated to making a difference in our community.

Position Summary: The Utilization Review Nurse assesses, plans, implements and evaluates the needs of patients for discharge planning and utilization review. This includes those who may have Medicare, Medicaid, HMO or private insurance to cover their stay at various units. Discharge planning is coordinated with physicians, Nursing, patient and family who have an ongoing caring relationship with the patient. Utilization review procedures include those stated for discharge planning in addition to knowledge of criteria for Medicare, Medicaid coverage and that of HMO or private insurers.

Qualifications:

  • Minimum of 1–3 years of related acute care nursing experience and completion of an accredited nursing program required.
  • Experience with Meditech Electronic Health Record (EHR) system preferred.
  • Must have working knowledge of criteria for Medicare, Medicaid, HMO and private insurance coverage.
  • Ability to maintain collaborative working relationships to ensure a positive and productive work environment.
  • Ability to plan and prioritize work with frequent interruptions.
  • Ability to provide exceptional customer service.
  • Effective verbal and written communication skills.
  • Knowledge and proficiency of hospital information technology applications.
  • Requires Current California Board of Nursing Registered Nurse License.
  • Current American Heart Association BCLS certificate required; ACLS certificate preferred.
  • CCM in Case Management preferred.

Madera Community Hospital provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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