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

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

Start Date: October 26, 2026

Location: Southern California (Remote Position)

Schedule: Day shift, 5x8-hour shifts (8:00 AM - 4:30 PM or 9:00 AM - 5:30 PM PST). Every other weekend rotation required. Patient caseload of approximately 40 cases weekdays, 60 cases weekends. 40 hours of orientation provided. Contract duration of 91 days (approximately 13 weeks).

Highlights:

• 100% remote position supporting multiple service lines and levels of care including inpatient, Extended Hospital Outpatient, and observation
• Work with diverse patient populations including pediatrics, adolescents, adults, and geriatrics across a variety of acute and chronic diagnoses
• Laptop, keyboard, and mouse provided
• Opportunity to support a centralized utilization management team across four facilities
• Flexible scheduling options with one pre-approved time off period available
• Must commit to working 3 of 5 major holidays (Thanksgiving, Christmas Eve, Christmas Day, New Year's Eve, New Year's Day)

Requirements:

• Active California Registered Nurse license required (Compact license accepted if California license obtained prior to start)
• Minimum 3 years of acute medical Care Manager/Utilization Management experience performing utilization review in a hospital setting (health plan or medical group experience alone is not sufficient)
• InterQual criteria experience required (hard requirement)
• Epic charting system proficiency with recent use within the last 6-12 months required
• Medicare knowledge required, including 2MN rule and other regulations regarding specific UM processes (CC44s, ABNs, HINNs, MCSNs, etc.)
• Experience with HMOs, IPAs, and California Medi-Cal preferred
• Strong knowledge of admission criteria, concurrent review, continued stay reviews, medical necessity determination, and prior authorization processes
• Two professional references covering one year within the last three years required

Why Join Us?

This remote utilization review position offers the flexibility of working from home while supporting a dynamic healthcare system across multiple facilities and service lines. You'll work with a collaborative interdisciplinary team managing diverse patient populations and complex cases. The role provides competitive compensation, comprehensive orientation, and the opportunity to expand your utilization management expertise across various care settings. Strict adherence to California labor laws ensures proper breaks and work-life balance, with overtime only permitted with prior leadership approval.