Temp LVN/LPN – Utilization Review Nurse

Intercare Holdings Insurance Services

Utilization review nurse position at AvonRisk reviewing medical necessity for services. The role includes validating diagnoses and communicating with various stakeholders.

Posted 7/10/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $20 - $31 per hourWebsite

About the role

Key responsibilities & impact

Review medical records to determine the medical necessity of a request for medical services.
Validate diagnosis and corresponding algorithms of care.
Evaluate for over-utilization of treatment requests inconsistent with evidence based guidelines.
Communicate with the claims examiner, providers, and any other auxiliary provider regarding UR determination.
Summarize medical records and all pertinent information for Physician Advisor.
Identify the need for medical case management and make recommendations for referral through supervisor.

Requirements

What you’ll need

Minimum of 3 years clinical experience
California Worker’s Compensation, Managed Care experience/Utilization Review experience desired
Needs to be familiar with California Worker’s Compensation regulations, medical terminology
Completion is IEA CA10 is required within one year of employment

Benefits

Comp & perks

Comprehensive medical, dental, and vision benefits
Company contributions to HSA and FSA plans
Employer paid life and disability insurance
401(k) with company match
Paid time off (PTO) and company paid holidays
Learning and development opportunities that support real career advancement
Employee assistance resources and a supportive culture that values balance and wellbeing

ATS Keywords

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Applicant Tracking System Keywords

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Soft Skills

Effective CommunicationAnalytical Skills

Certifications

IEA CA10 Certification