Utilization Review RN
Torrance, CA
American Consultants
5x8 hrs, Days
Referral Bonus

Job Opportunity – Registered Nurse, Utilization Review – Torrance, CA 90503

Start Date: October 5, 2026

Location: Torrance, California (Remote position)

Schedule: Day shift, 5x8-hour shifts (08:00 - 16:30 or 09:00 - 17:30 PST). Every third weekend rotation required. 91-day assignment through January 4, 2027. Patient caseload of approximately 40 cases. Must commit to working 3 of 5 major holidays during the contract period.

Highlights:

• 100% remote Utilization Management position supporting multiple service lines and levels of care including inpatient, Extended Hospital Outpatient, and observation
• Work with a variety of adult and pediatric acute and chronic diagnoses across all age groups
• Laptop, keyboard, and mouse provided for remote work
• 40 hours of paid orientation to support your transition into the role
• Opportunity to support three facilities with diverse patient populations and care settings
• Flexibility to work within Pacific Standard Time zone from your remote location

Requirements:

• Active California Registered Nurse license required (non-negotiable)
• Minimum 3 years of acute medical Care Manager/Utilization Management experience performing utilization review in a hospital setting (not health plan or medical group)
• Epic charting system proficiency required with recent use within the last 6-12 months
• InterQual criteria experience required (hard stop requirement)
• Medicare knowledge and experience with Medicare regulations including CC44s, ABNs, HINNs, and MCSNs (hard stop requirement)
• Experience with HMOs, IPAs, and California Medi-Cal programs strongly preferred
• Demonstrated skills in concurrent review, continued stay reviews, medical necessity determination, prior authorizations, and retrospective review
• Knowledge of admission criteria, care coordination, CPT coding, DRG classification, and HIPAA guidelines
• Two professional references covering one year of experience within the last three years

Why Join Us?

This remote Utilization Review position offers the opportunity to work with a diverse patient population across multiple care settings while maintaining work-life balance from home. You'll be supported with comprehensive orientation, provided equipment, and the flexibility of remote work while contributing to quality patient care coordination. The role provides exposure to various service lines and the chance to apply your clinical expertise in utilization management across inpatient, outpatient, and observation settings. Strict adherence to California labor laws ensures proper breaks and work-life boundaries, with no unauthorized overtime.