Travel
Registered Nurse
Torrance, CA
Utilization Review Nurse — 100% Remote | Torrance, CA (Pacific Time)
Day Shift | 13-Week Contract
This fully remote Utilization Review (UR) position supports a centralized UM team covering inpatient, Extended Hospital Outpatient, and observation service lines across multiple facilities. All work is performed in Pacific Standard Time; equipment (laptop, keyboard, and mouse) is provided.
Shift & Schedule
- Days, 5×8-hour shifts (8:00 AM – 4:30 PM or 9:00 AM – 5:30 PM PST)
- Every third weekend rotation required for the duration of the contract
- Holiday coverage required (must commit to 3 of 5: Thanksgiving, Christmas Eve, Christmas Day, New Year's Eve, New Year's Day)
Required Qualifications
- Minimum 3 years of acute hospital Care Management/Utilization Management experience — hospital setting required (health plan or medical group experience does not qualify)
- Active California RN license required
- Proficiency with InterQual criteria — hardstop
- Medicare knowledge (CC44s, ABNs, HINNs, MCSNs) — hardstop
- Familiarity with HMOs, IPAs, and CA Medi-Cal regulations strongly preferred
Clinical Scope
- Concurrent review, continued stay reviews, pre-certification, and retrospective review
- Medical necessity determination per evidence-based guidelines
- Patient population includes adolescents, adults, pediatrics, and geriatrics with a variety of acute and chronic diagnoses
- DRG knowledge, CPT coding familiarity, and CMS/HIPAA compliance required
Additional Expectations
- Flexibility to support multiple facilities as part of a centralized team
- Strict adherence to California labor laws (lunches, breaks); zero unapproved overtime
- 40-hour orientation