RN UTILIZATION REVIEW COORDINATOR

Children’s Physicians Medical Group (CPMG) has an exciting opportunity for a dedicated and caring professional to join our team as a RN Utilization Review Coordinator. This is a full-time hybrid remote position. This team member will work with all members of the health care team to coordinate the delivery of care through assessment, planning, facilitation, and patient advocacy to ensure cost-effective quality outcomes of care. Additionally, this position will establish and maintain efficient methods of ensuring the medical necessity and appropriateness of all requested services, in both the inpatient and ambulatory setting.

The ideal candidate will possess:

• Registered Nurse with current unrestricted California License.
• Minimum of three years clinical experience, with pediatric background preferred.
• At least two years managed care with utilization review and authorization experience.
• Good computer skills with knowledge of Excel, Word, PowerPoint, Outlook, and Access.
• Excellent verbal and written communication skills.
• Strong analytical and problem-solving skills.

The reasonably expected starting hourly wage range for this position is $42.00-$44.00 per hour depending on qualifications including education and relevant experience.

Schedule:

• 8-hour shift
  Monday to Friday

Experience:

• Utilization review: 1 year (Preferred)

License/Certification:

• unrestricted CA RN (Required)

Work Location:

• Hybrid remote in San Diego, CA 92111