Registered Nurse -Utilization Review Case Manager
Listed on 2026-02-03
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Nursing
Healthcare Nursing, Clinical Nurse Specialist
Registered Nurse – Utilization Review Case Manager – 8 Hour Days
Join to apply for the Registered Nurse – Utilization Review Case Manager – 8 Hour Days role at Cedars‑Sinai
.
Are you ready to bring your expert clinical skills to a world‑class facility recognized as one of the top ten in the United States? Do you have a passion for the highest quality and patient happiness? Then please respond to this dynamic opportunity available with one of the best places to work in Southern California!
Summary of Essential Duties- The Utilization Management (UM) Registered Nurse – Medicare Short‑Stay & Concurrent Denials supports post‑discharge clinical reviews for Medicare Short‑Stay cases and assists with real‑time management of concurrent payer denials.
- This role ensures timely, accurate, and compliant clinical validation in accordance with CMS requirements and payer timelines. The UM RN collaborates with physicians, revenue integrity, and payer partners to complete post‑discharge reviews, prepare defensible clinical submissions, coordinate peer‑to‑peer reviews, and respond to concurrent denials.
- This position requires strong regulatory knowledge, sound clinical judgment, and the ability to manage high‑volume, time‑sensitive work while protecting revenue, compliance, and operational stability.
- Associate Degree/College Diploma graduate of an accredited nursing program
- Bachelor's Degree in Nursing
- RN State License
- Basic Life Support (BLS)
- 3 years in acute nursing
- 2 years in case management
- 1 year in CPT coding
Lifting 50 lbs., carrying 50 lbs., pushing 75 lbs., pulling 75 lbs., balancing, stooping, kneeling, crouching, reaching, handling, grasping, feeling, talking, hearing, repetitive motions, eye/hand/foot coordination.
Req : 14355
Working Title :
Registered Nurse – Utilization Review Case Manager – 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 : $52.47 – $83.95
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