UM Nurse Reviewer, RN - Bakersfield 1.1

Location: Bakersfield, CA 93309 (Onsite)

Classification: Full-Time

This position is non-exempt and will be paid on an hourly basis.

Schedule: Monday-Friday 8am-5pm

Benefits:

· Medical

· Dental

· Vision

· Simple IRA Plan with Employer Contribution

· Employer Paid Life Insurance

· Employee Assistance Program

Compensation: The initial pay range for this position upon commencement of employment is projected to fall between $31.00 and $38.74 for a California Licensed LVN & $43.35 and $54.18 for a California Licensed RN. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.

Position Summary:

Under the guidance of the Utilization Management, the UM Nurse Reviewer will leverage expertise to conduct timely reviews of pre-certification and/or concurrent requests, aligning with established policies. The UM Nurse Reviewer holds responsibility for ensuring that members receive suitable care at the right time and location, all while adhering to federally and state regulated

turn-around times. This role involves reviewing services to guarantee the fulfillment of medical necessity, applying clinical knowledge to ensure proper benefit utilization, facilitating secure and efficient discharge planning, and collaborating closely with internal and external stakeholders to address the multifaceted needs of the member.