Registered Nurse - Utilization Review Case Manager - PER DIEM
Listed on 2026-01-23
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Nursing
Healthcare Nursing, Clinical Nurse Specialist
Registered Nurse - Utilization Review Case Manager - PER DIEM - 8 Hour Days
Join to apply for the Registered Nurse - Utilization Review Case Manager - PER DIEM - 8 Hour Days role at Cedars‑Sinai
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When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of happiness, passion, and dedication pulses through Cedars‑Sinai, and it’s just one of the many reasons why we rank as one of the top hospitals in the nation by U.S. News & World Report.
Cedars‑Sinai Medical Center is an organization known nationally for excellence in cancer treatment, research, and education.
We are seeking a highly motivated Administrative Assistant to provide administrative support and contribute to our mission of providing world‑class health care and the best quality service to our patients and communities. We invite you to consider this exciting opportunity and share with us your skills!
What will you be doing in this role?
The Utilization Review Case Manager validates the patient's placement to be at the most appropriate level of care based on nationally accepted admission criteria. The UR Case Manager uses medical necessity screening tools, such as Inter Qual or MCG criteria, to complete initial and continued stay reviews in determining appropriate level of patient care, appropriateness of tests/procedures and an estimation of the patient's expected length of stay.
The UR Case Manager secures authorization for the patient's clinical services through timely collaboration and communication with payers as required. The UR Case Manager follows the UR process as defined in the Utilization Review Plan in accordance with the CMS Conditions of Participation for Utilization.
- Bachelor of Science, Nursing (BSN) required
- Master's Degree, Nursing (MSN) preferred
- Current, unrestricted California RN License required
- BLS from the American Heart Association or American Red Cross required
- Certified Case Management RN preferred
- A minimum of 5 years of acute care nursing experience required
- A minimum of 2 years of case management experience required
- At least 3 years of ED nursing experience preferred
- Emergency Department Case Manager experience preferred
- Experience using Inter Qual or Milliman required
- High level of competency performing medical necessity reviews with accepted criteria required
Req
Working Title:
Registered Nurse - Utilization Review Case Manager - PER DIEM - 8 Hour Days
Department:
Utilization Management
Business Entity:
Cedars-Sinai Medical Center
Job Category:
Patient Services
Job Specialty: RN
Overtime Status: NONEXEMPT
Primary Shift: Day
Shift Duration: 8 hour
Base Pay: $67.50 - $68.49
Seniority level:
Not Applicable
Employment type:
Full-time
Job function:
Health Care Provider
Industries:
Hospitals and Health Care, IT Services and IT Consulting, and Research Services
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