California Licensed Care Review RN

A company is looking for a RN- Care Review Clinician specializing in Utilization Review (Remote- CA License Required). Key Responsibilities Assess services for members to ensure optimal outcomes and compliance with regulations Analyze clinical service requests against evidence-based clinical guidelines Conduct reviews for prior authorization and collaborate with multidisciplinary teams Required Qualifications At least 2 years of experience in hospital acute care, inpatient review, or managed care Active and unrestricted Registered Nurse (RN) license in the state of practice Ability to prioritize and manage multiple deadlines Proficiency in Microsoft Office suite/applicable software programs Experience in utilization review or prior authorization is desirable