UM Nurse Reviewer - Utilization Specialist
Job in
Orange, Orange County, California, 92613, USA
Listed on 2026-07-29
Listing for:
Astiva Health, Inc
Full Time
position Listed on 2026-07-29
Job specializations:
-
Nursing
Job Description & How to Apply Below
Astiva Health, Inc., located in Orange, CA, is seeking an experienced Utilization Management Authorization Review Nurse to oversee inpatient and outpatient utilization, reviewing clinical documentation and applying CMS and health plan criteria to determine medical necessity and coverage.
The role emphasizes timely processing, clear notification letters, and collaboration with UM, compliance, and Appeals teams to support patient care within regulatory guidelines.
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