Utilization Review RN
Location: Duarte, CA
Contract Type: Travel Contract
Shift Type: NOC
Hours per Week: 40 hrs per week
Candidate Pay Rate: Competitive pay (market-based, commensurate with experience)
About United Health Care Staffing
At United Health Care Staffing (UHC Staffing), we believe healthcare staffing should be more than just finding a job. We are here to connect amazing professionals with opportunities that make their careers exciting, rewarding, and meaningful. With us, you're not just signing up for a contract you are joining a team that's got your back, answers your calls, and maybe even cracks a joke or two to brighten your day. Think of us as the travel buddy who handles the logistics while you focus on what you do best helping people heal.
Roles & Responsibilities
- Conduct timely utilization reviews using EPIC and InterQual to determine medical necessity
- Document clear, standards-based findings in EPIC and communicate using SBAR
- Coordinate care with interdisciplinary teams including Pharmacy, PT, Respiratory, Social Services and more
- Perform concurrent, continued stay and retrospective reviews to support quality and compliance
- Complete prior authorization and pre-cert reviews and assist with appeals and denials
- Analyze charts and abstract data to support accurate coding, documentation and decision-making
- Support discharge planning and care coordination to improve patient transitions and outcomes
Qualifications
- Active RN license in California (required)
- Minimum 3 years clinical experience (required)
- EPIC experience (required) — you should be comfortable charting in Epic
- BLS certification (required)
- CMC certification preferred
- Previous charge or leadership experience preferred
- Travel/contract experience required — no first-time travelers
- COVID-19 vaccine + booster required (medical/religious exemptions allowed); flu vaccine required per facility policy
Education
- Active Registered Nurse (RN) license — BSN preferred
Knowledge & Skills
- Strong command of InterQual and Milliman criteria for Utilization Review
- Knowledge of CPT coding, ICD-10, DRG and Medicare/Medicaid (CMS) rules
- Familiarity with HEDIS, NCQA, The Joint Commission standards and OSHA
- Experience with prior authorizations, concurrent review, appeals and denials
- Excellent communication, critical thinking, time management and problem-solving
- Comfortable with data abstraction, quality improvement and documentation best practices
- Ability to use SBAR communication style and collaborate across departments
Benefits
- Competitive weekly pay to keep your wallet happy
- Medical, Dental & Vision coverage to keep you healthy
- 401(k) retirement savings plan so you can plan ahead
- Paid Time Off to recharge and come back stronger
- Licensure assistance & reimbursement to ease the paperwork pain
- Travel reimbursement to cover your commute while on assignment
- Referral bonus program — bring a friend, earn rewards
- A supportive team that values your expertise and well-being
Travel Perks: Explore Duarte, CA
Duarte sits in the scenic San Gabriel Valley with easy access to hiking in the Angeles National Forest and trails like Eaton Canyon. Enjoy nearby Old Town Pasadena for dining, shopping and cultural stops including the Norton Simon Museum and the Huntington Library & Botanical Gardens. Sports fans and weekend explorers can visit the Rose Bowl, Pasadena events, or drive ~30–45 minutes to downtown Los Angeles attractions and coastal beaches when you want a quick getaway.
Apply Now
Ready to start your next adventure as a Utilization Review RN? Let's get you moving forward!
Send your resume to [email protected] or call us at 408-441-9200 today.
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