Medical Claims Review Nurse

  • Location
    San Diego, California
  • Job type
  • Category
    Medical & Science - Nursing

A contract Utilization Review Nurse - Senior job in San Diego, CA is available through Adecco Medical and Science. You will be responsible to review inpatient cases and present at daily inpatient rounds. You will generate authorizations based on discharge planning.

Utilization Review Nurse - Senior job responsibilities include:

Documents MCG Guideline(s) on every inpatient case within 24 hours of receipt and updates guideline as hospitalization continues
Daily onsite rounds, reviewing of medical records, concurrent review, and discharge planning on inpatients
Daily inpatient rounds with Hospitalists
Analyzes medical cases for appropriateness and plans and coordinates all phases of care in conjunction with the Hospitalist, attending Physician


Must have qualifications/experience:
Current CA LVN License
1 year manage care experience or related healthcare experience.
2-4 years in acute care (ICU, CCU, Med-Surg, SNF)

Shift Start/End Time: 8 am - 5 pm; Monday - Friday

If you are interested in this Utilization Review Nurse - Senior position in San Diego then please click APPLY NOW. For other opportunities available at Adecco Medical and Science go to If you have questions about the position, please contact Stephanie Pack by email at:

Equal Opportunity Employer Minorities/Women/Veterans/Disabled

  • Apply with Adecco

Reference number US_EN_2_108175_328708