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Registered Nurse -Utilization Review Case Manager - 8 Hour Days
Cedars Sinai
Application
Details
Posted: 03-Feb-26
Location: Los Angeles, California
Internal Number: 14355
Job Description
Are you ready to bring your expert clinical skills to a world-class facility recognized as one of the top ten in the United States? Do you have a passion for the highest quality and patient happiness? Then please respond to this dynamic opportunity available with one of the best places to work in Southern California! We would be happy to hear from you!
When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of happiness, passion and dedication pulses through Cedars-Sinai, and it?s just one of the many reasons we?ve achieved our fifth consecutive Magnet designation for nursing excellence. From working with a team of dedicated healthcare professionals to using state-of-the-art facilities, you?ll have everything you need to do something incredible-for yourself, and for others. Join us, and discover why U.S. News & World Report has named us one of America?s Best Hospitals.
Summary of Essential Duties:
The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent Denials supports post-discharge clinical reviews for Medicare Short Stay cases and assists with real-time management of concurrent payer denials.
This role ensures timely, accurate, and compliant clinical validation in accordance with CMS requirements and payer timelines. The UM RN collaborates with physicians, revenue integrity, and payer partners to complete post-discharge reviews, prepare defensible clinical submissions, coordinate peer-to-peer reviews, and respond to concurrent denials.
This position requires strong regulatory knowledge, sound clinical judgment, and the ability to manage high-volume, time-sensitive work while protecting revenue, compliance, and operational stability.
Qualifications
Educational Requirements:
Assoc. Degree/College Diploma Graduate of an accredited nursing program Bachelor's Degree Nursing
Licenses:
RN State License Basic Life Support (BLS)
Experience:
3 years In acute nursing 2 years Case Management 1 year CPT coding
Req ID : 14355 Working Title : Registered Nurse -Utilization Review Case Manager - 8 Hour Days Department : Utilization Management Business Entity : Cedars-Sinai Medical Center Job Category : Patient Services Job Specialty : RN Overtime Status : NONEXEMPT Primary Shift : Day Shift Duration : 8 hour Base Pay : $52.47 - $83.95
