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⏰ Full-time

RN Utilization Review

Dignity Health
Location 📍 Santa Cruz, United States
Posted 📅 June 15, 2026
Work Type ⏰ Full-time

Position Overview

**Job Summary and Responsibilities**

Responsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and critical thinking. Collaborates with the Concurrent Denial RNs to determine the root cause of denials and implement denial prevention strategies. Collaborates with Patient Access to establish and verify the correct payer source for patient stays and documents the interactions. Obtains inpatient authorization or provides clinical guidance to Payer Communications staff to support communication with the insurance providers to obtain admission and continued stay authorizations as required within the market.

**Job Requirements**
**Requirements:**

+ Graduate of an accredited school of nursing upon hire
+ Minimum two (2) years of acute hospital clin...

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Job Details

Employment Type
Full-time
📊
Category
other-general
🏠
Work Arrangement
On-site
📍
Location
Santa Cruz, United States