What are the responsibilities and job description for the Utilization Review Nurse position at Accede Solutions Inc (accedesolution.com)?
Job Description – RN Utilization Review (Remote)
We are hiring an experienced RN for a Utilization Review role .This is a 13-week contract, fully remote, supporting multiple facilities and working in Pacific Standard Time.
Key Responsibilities:
- Perform utilization review, concurrent and retrospective reviews.
- Assess medical necessity using InterQual (required).
- Complete prior authorizations, admission reviews, denials, and audits.
- Document reviews in Epic (recent experience required).
- Ensure compliance with CMS, Medicare, and regulatory guidelines.
Requirements:
- 3 years acute care UM/Care Manager experience in a hospital setting.
- Seasoned traveler (required).
- InterQual & Epic experience (Hardstop).
- Active CA RN license. Required
Details:
- Shift: Days, 5x8 (8 AM–4:30 PM)
- Contract: 13 weeks, remote
- Location: Apple Valley, CA (PST schedule)
- Weekends: Minimum 4 per contract
Salary : $40 - $42