LanceSoft is seeking a travel nurse RN Utilization Review for a travel nursing job in Duarte, California.
2995607
Utilization Review RN position working two 12-hour day shifts each weekend (Saturday and Sunday). Responsibilities include case management and utilization review functions such as admission criteria, concurrent/continued stay reviews, prior authorizations, discharge planning, audits, appeals/denials, and medical necessity determinations using InterQual and Milliman criteria. Additional responsibilities include compliance with CMS, HIPAA, DRGs, CPT/ICD-10 coding, and NCQA/HEDIS standards. Provider support services include pharmacy, respiratory, PT, interpretation, phlebotomy, social services, and transportation. Business casual dress code. Ax
Eligibility & Requirements
Requirement Details
Experience 3 years required
Travel Experience Yes, required
Charge Experience Preferred
Education BSN required
License CA RN license in hand upon submission (no EMSA, no pending)
Certifications BLS required, CMC preferred
Charting Epic required
Chemo Cert Required for all RN roles (except phone triage & case management, but still encouraged)
Orientation 16 hours, non-billable
Patient Ratio 1:15 (review caseload, not direct care)
Age Groups Adolescents, Adults, Pediatrics, Geriatrics
Weekend Requirement Yes, Sat/Sun shifts
OT Must be approved daily by Charge RN with Nursing Staffing Office
RTO Allowed, no restrictive rules
Locals Accepted at reduced local rate (within 75 miles)
Former Employees Not eligible until cleared by facility
Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization. Lancesoft Inc. is one of the highest rated companies in the industry. We have been recognized as one of the Largest Staffing firms and ranked in the top 50 fastest Growing Healthcare Staffing firms in 2022. Lancesoft offers short- and long-term contracts, permanent placements, and travel opportunities to credentialed and experienced professionals throughout the United States. We pride ourselves on having industry leading benefits. We understand the importance of partnering with an expert who values your needs, which is why we’re 100% committed to finding you an assignment that best matches your career and lifestyle goals. Our team of experienced career specialists takes the time to understand your needs and match you with the right job Lancesoft has been chosen by Staffing Industry Analysts as one of the Best Staffing Firms to Work for.LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities, Home Health & Community Health, Urgent Care Clinics, and many other provider-based facilities.
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