RN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr
Covina, California
Overview
As a nurse at Emanate Health, you are a source of healing. You put patients first every day. We provide our nursing family with the support they need to be successful in their current roles and give them the tools and experience to reach their future goals.
- Schedule: Varies
- Experience Preferred
- Travel: No
- Glassdoor Reviews and Company Rating
Success Profile
What makes a successful Nurse at Emanate Health? Check out the traits we’re looking for and see if you have the right mix.
- Balanced
- Collaborative
- Compassionate
- Patient
- Sincere
- Versatile
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Medical
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Dental
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Vision
Benefits
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401(k)/
Retirement Plans -
Tuition Reimbursement
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Work-Life Balance
RN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr
Covina, California
Job Title RN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr Company Name Emanate Health Employment Type Full Time Location Covina, California Job ID R0012363 Date posted 02/07/2025 Campus/Location Corporate Badillo St. - CovinaNote: Please read the complete description below before applying for this job.
Current Emanate Health Employees - Please log into your Workday account to apply
Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals.
On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country.
Job Summary
The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying clinical acumen and the appropriate application of policies and guidelines to urgent and standard reviews. You will document decisions using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings.
Job Requirements
Minimum Education Requirement :
Minimum Experience Requirement :
Minimum of three years of utilization managementexperience. Experience in quality- related job preferred. Computer proficiency is required. Excellent customer service skills required.
Minimum License Requirement :
California RN license.
Delivering world-class health care one patient at a time.
Pay Range:
$52.03 - $80.64Culture
Emanate Health employees are linked together by one common mission – helping people keep well in body, mind and spirit by providing quality health care services in a safe, compassionate environment. That mission sets the tone for our workplace culture. From the people we hire to the facilities we build, Emanate Health is about helping others.
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We do it for Our Patients
Our patients are at the center of everything we do, and everyone at Emanate Health plays a vital role in the care we deliver. That's because no matter what your job title is, the work you do at Emanate Health affects people's lives.
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We Support Our Employees
Respect and support for our employees is integral to our workplace culture. That's helped us earn the awards "Best Place to Work" and "Best Hospital" by the San Gabriel Valley Tribune.
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Our Values Guide Us
Our values ensure respect, excellence, compassion, integrity and stewardship in the daily work we do.
