Utilization Review RN – Per Diem

Providence

Utilization Review RN conducting clinical reviews and managing diverse workload in fast-paced environment for Southern CA ministries. Requires strong clinical background and remote experience.

Posted 7/31/2026part-timeRemote • California • 🇺🇸 United StatesJuniorMid-Level💰 $57 - $89 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in conducting utilization reviews and clinical assessments within a fast-paced healthcare environment, leveraging strong negotiation and communication skills. Holds a California Registered Nurse License and possesses experience with Interqual guidelines in a multi-hospital system.

Highest-signal resume keywords

California Registered Nurse LicenseUtilization Review ExperienceClinical Review SkillsInterqual Guidelines ExperienceNegotiation Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ReviewClinical ReviewMedical Record ReviewAcute Hospital Case ManagementRegulatory Compliance

Soft Skills

Communication SkillsProblem-Solving SkillsDecision-Making Skills

Certifications & Qualifications

Associate's Degree in NursingBachelor's Degree in NursingMaster's Degree in Nursing

Industry Keywords

Healthcare SystemMulti-Hospital SystemRemote UR Environment

About the role

Key responsibilities & impact

Provide prospective, retrospective, and concurrent utilization reviews for Southern CA ministries.
Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans.
Effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment.
Demonstrate excellent negotiation, communication, problem-solving, and decision-making skills.

Requirements

What you’ll need

Associate's Degree in Nursing.
Upon hire: California Registered Nurse License.
2 years of experience working in a remote UR environment or working as an acute hospital case manager.
Bachelor's Degree in Nursing (preferred).
Master's Degree in Nursing (preferred).
Experience working with Interqual guidelines (preferred).
Experience in a multi-hospital and/or integrated healthcare system (preferred).

Benefits

Comp & perks

Comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching
Health care benefits (medical, dental, vision)
Life insurance
Disability insurance
Time off benefits (paid parental leave, vacations, holidays, health issues)
Voluntary benefits
Well-being resources