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Internship Rn Utilization Review Nurse Jobs in California

Medix

Utilization Review Nurse

Orange, CA · On-site

$38 - $53/hr

Job Summary Our client is seeking a Utilization Review Nurse responsible for managing the complete ... Active and unencumbered California RN or LVN License. * Strongly prefer 5+ years of concurrent ...

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Internship Rn Utilization Review Nurse information

What are the key skills and qualifications needed to thrive as an Internship RN Utilization Review Nurse, and why are they important?

To thrive as an Internship RN Utilization Review Nurse, you need a solid foundation in nursing principles, clinical assessment, and case management, typically supported by an RN license and current enrollment in a nursing program. Familiarity with medical coding systems (like ICD-10 or CPT), electronic health records (EHRs), and utilization review software is often required. Strong analytical thinking, communication skills, and attention to detail set candidates apart in this role. These competencies are crucial for ensuring appropriate patient care, regulatory compliance, and effective resource utilization within healthcare organizations.

What types of tasks and learning experiences can I expect as an Internship RN Utilization Review Nurse?

As an Internship RN Utilization Review Nurse, you will typically assist experienced utilization review nurses in evaluating patient records, verifying the necessity of medical procedures, and ensuring compliance with insurance or regulatory guidelines. You'll gain exposure to interdisciplinary communication by collaborating with physicians, case managers, and insurance representatives. This role provides valuable insight into how clinical decisions impact both patient outcomes and healthcare costs, helping you develop analytical and communication skills essential for future advancement. Expect to participate in chart reviews, learn about medical necessity criteria, and attend case discussions as part of your hands-on learning.

What is an Internship RN Utilization Review Nurse?

An Internship RN Utilization Review Nurse is a registered nurse who is in a training or internship phase to learn how to evaluate the necessity, appropriateness, and efficiency of healthcare services provided to patients. This role involves reviewing patient records, coordinating with healthcare providers, and ensuring that treatments meet established guidelines and insurance requirements. The internship provides hands-on experience in the field of utilization review, helping nurses transition from direct patient care to a more administrative or case management-focused role. It is an entry-level opportunity for RNs interested in healthcare quality and cost management.

What is the difference between Internship Rn Utilization Review Nurse vs Utilization Review Nurse?

AspectInternship Rn Utilization Review NurseUtilization Review Nurse
CredentialsRN license, internship or training programRN license, certification in utilization review often preferred
Work EnvironmentTraining setting, supervised, learning-focusedClinical or office setting, independent review tasks
Job ResponsibilitiesAssisting in review processes, gaining experiencePerforming utilization reviews, making coverage decisions

Internship Rn Utilization Review Nurse is a training role for nursing students or new graduates gaining experience, while Utilization Review Nurse is a full-time professional responsible for evaluating medical necessity and coverage. The internship role focuses on learning, whereas the utilization review nurse performs independent assessments in healthcare settings.

What are popular job titles related to Internship Rn Utilization Review Nurse jobs in California? For Internship Rn Utilization Review Nurse jobs in California, the most frequently searched job titles are:
What job categories do people searching Internship Rn Utilization Review Nurse jobs in California look for? The top searched job categories for Internship Rn Utilization Review Nurse jobs in California are:
What cities in California are hiring for Internship Rn Utilization Review Nurse jobs? Cities in California with the most Internship Rn Utilization Review Nurse job openings:
Internship Rn Utilization Review Nurse jobs near you
Infographic showing various Internship Rn Utilization Review Nurse job openings in California as of August 2026, with employment types broken down into 50% Full Time, 17% Part Time, and 33% Contract. Highlights an 83% In-person, and 17% Remote job distribution.

Registered Nurse - Utilization Review (Remote)

Talencia

Torrance, CA • On-site

$57/hr

Contractor

Re-posted 20 days ago

Job description

Job Title: RN - Utilization Review (Remote) 
Location: Remote – Must work in Pacific Standard Time (PST)
Duration: 13 Weeks
Unit: Remote Utilization Management
Pay Rate: $54/hr (W2) or $57/hr (1099)
 
Shift & Schedule
  • Schedule: Monday to Friday, 5x8-Hour Days
  • Hours: 08:00 AM – 04:30 PM (PST)
  • Weekend Requirement: Every third weekend
Position Summary
We are seeking a Registered Nurse (RN) with a strong background in Utilization Review to work remotely.
This role involves reviewing medical necessity, documentation, and level of care decisions across multiple hospitals and service lines.
Key Responsibilities
  • Perform utilization review for inpatient, observation, and extended outpatient cases
  • Apply InterQual criteria (required – Hardstop)
  • Use Epic for documentation and review workflows (recent use within 6–12 months required)
  • Interpret and apply Medicare rules and documentation (e.g., CC44s, ABNs, HINNs, MCSNs)
  • Rotate across three hospital systems under centralized UM
  • Adhere to California labor laws (breaks, meals, and time reporting)
Required Qualifications
  • Active CA RN License
  • Minimum 3 years of acute care CM/UM experience in a hospital setting (not health plan or medical group)
  • InterQual experience (Hardstop)
  • Recent Epic use (within the last 6–12 months)
  • Strong understanding of Medicare, HMO, and IPA processes
  • High attention to detail, organizational, and communication skills
  • Comfortable working independently in a fully remote environment