Full-Time Review Nurse jobs in Monterey Park, CA

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UM REVIEW NURSE

Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment. Refer cases to Medical Directors as needed/appropriate. Maintain kno...

CompanyAstrana Health
AddressMonterey Park, CA
CategoryEducation/Training
Job typeFull-Time
Date Posted 2 months ago See detail

UM Review Nurse

Astrana Health

Monterey Park, CA

Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment. Refer cases to Medical Directors as needed/appropriate. Maintain kno...

Denial Review Nurse - Utilization Management - Hybrid

Astrana Health

Monterey Park, CA

$30 - $45 an hour

Responsible for managing all deferrals and or denials by conducting a comprehensive review of clinical documentation, clinical criteria/guideline, policy, and or EOC/benefit policy Apply clinical knowledge when processing all defe...