TRA Utilization Review Remote - California RN License Job at Tenet Healthcare, Miami, FL

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  • Tenet Healthcare
  • Miami, FL

Job Description

*This position requires that you already posses a California Nursing license. Position requires servicing patient files and hospitals in the state of California*

*This position is remote withe the number of hours varying per week between 20 - 24. Preferred candidate lives in California*

The RN Utilization Review is repsonsible for integrates national standards for case management scope of services including Utilization Management supporting medical necessity and denial prevention, coordination with payers to authorize appropriate level of care and length of stay for medically necessary services required for the patient, compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy. Also, Education provided to payers, physicians, hospital/office staff and ancillary departments related to covered services and administration of benefits.

Job Tags

Remote job,

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