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Intern Insurance Utilization Review Jobs in California

Corvel

Utilization Review Supervisor RN

Rancho Cucamonga, CA · On-site

$77K - $120K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Utilization Review Supervisor RN is responsible for directing the operations of their ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

Corvel

Utilization Review Supervisor RN

Rancho Cucamonga, CA · Remote

$77K - $120K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Utilization Review Supervisor RN is responsible for directing the operations of their ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

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All JobsIntern Insurance Utilization Review JobsIntern Insurance Utilization Review Jobs in California

Intern Insurance Utilization Review information

What is the difference between Intern Insurance Utilization Review vs Insurance Claims Processor?

AspectIntern Insurance Utilization ReviewInsurance Claims Processor
CredentialsTypically pursuing or holding a relevant degree (e.g., health administration, nursing)High school diploma or equivalent; some roles may require insurance or claims processing certifications
Work EnvironmentHealthcare settings, insurance companies, or administrative officesInsurance companies, healthcare providers, or claims processing centers
Primary ResponsibilitiesAssisting in reviewing medical necessity, supporting utilization review processesProcessing and reviewing insurance claims for accuracy and completeness

Intern Insurance Utilization Review focuses on evaluating medical necessity and supporting healthcare decision-making, often involving review of patient records. Insurance Claims Processors handle the administrative task of reviewing and processing insurance claims for payment. While both roles involve insurance and healthcare, utilization review emphasizes clinical assessment, whereas claims processing centers on administrative claim management.

What skills and qualifications are needed to thrive as an intern insurance utilization review?

To thrive as an Intern in Insurance Utilization Review, you typically need a background in healthcare administration or a related field, along with strong analytical and organizational skills. Familiarity with electronic health records (EHRs), insurance databases, and claims processing systems is often required. Attention to detail, effective communication, and the ability to collaborate with both clinical and administrative teams are essential soft skills. These competencies ensure accurate review of insurance claims, compliance with regulations, and efficient coordination between healthcare providers and insurers.

What does an intern insurance utilization review do?

An Intern Insurance Utilization Review assists with evaluating medical records and insurance claims to ensure that healthcare services are medically necessary and covered by insurance policies. They work under supervision to review documentation, communicate with healthcare providers, and help determine if treatments meet established guidelines. This role provides valuable exposure to the insurance and healthcare industries, helping interns learn about claims processing, policy compliance, and the importance of cost-effective care.
What are the most commonly searched types of Insurance Utilization Review jobs in California? The most popular types of Insurance Utilization Review jobs in California are:
What cities in California are hiring for Intern Insurance Utilization Review jobs? Cities in California with the most Intern Insurance Utilization Review job openings:
Intern Insurance Utilization Review jobs near you

Registered Nurse Utilization Review

vTech Solution

Santa Rosa, CA • On-site

Other

Re-posted 14 days ago

Job description

Job Summary:
We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, Operating Room. The Registered Nurse will be responsible for providing skilled nursing care, case management, and hospice care to individuals facing advancing age, frailty, and serious illness. Daily tasks include patient assessments, medication administration, treatment planning, and collaborating with the interdisciplinary team. Critical to this role is strong communication and strong collaboration with patients, providers, and other members of our team. At least 2 years of experience and exceptional skill is required.
Responsibilities:
  • Conduct patient assessments and monitor patient conditions.
  • Administer medications and treatments as prescribed.
  • Develop and implement individualized treatment plans.
  • Collaborate with interdisciplinary teams including physicians, therapists, and social workers.
  • Provide case management and hospice care for patients with advancing age, frailty, and serious illness.
  • Document patient care activities and maintain accurate medical records.
  • Communicate effectively with patients, families, and healthcare providers.
Required Skills & Certifications:
  • Active Registered Nurse license in the state of employment.
  • Bachelor's degree in Nursing or related field.
  • Minimum of 2 years' experience in hospital, home health, or hospice care.
  • Clinical assessment, medication administration, and treatment planning skills.
  • Interdisciplinary team collaboration skills.
  • Excellent communication and interpersonal skills.
  • Driver's license, car insurance, and automobile for field work.
Preferred Skills & Certifications:
  • Experience in Utilization Review or case management roles.
  • Specialty certifications relevant to Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, or Operating Room nursing.
  • Advanced certifications such as CCRN, CMC, or CHPN.
Special Considerations:
  • May require occasional field visits necessitating reliable transportation.
  • Strong ability to work independently in remote settings.
  • Must be able to handle fast-paced and complex clinical situations.
Scheduling:
  • Remote work with flexible scheduling based on utilization review caseload.
  • Standard business hours with potential for occasional extended hours as needed.
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About vTech Solution

Sourced by ZipRecruiter

vTech is a Managed IT Services firm based out of Washington DC with a primary focus on Cloud Computing and Managed Network Security.

Industry

It services

Company size

51 - 200 Employees

Headquarters location

Washington, DC, US

Year founded

2006

Social media

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