Actalent
Join to apply for the Utilization Review Nurse role at Actalent.
About the Role We’re looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective patient care from a fully remote environment. This role is ideal for nurses who enjoy clinical evaluation, structured decision‑making, and collaborating with providers to ensure appropriate levels of care.
Key Responsibilities
Conduct utilization reviews for inpatient, outpatient, and ancillary services using established clinical criteria
Assess medical necessity and determine appropriate levels of care
Document clinical findings accurately within internal systems
Communicate with providers to obtain additional clinical information when needed
Support denial management, including appeals and peer‑to‑peer review processes
Ensure regulatory compliance with payer guidelines and organizational policies
Identify care coordination needs and refer cases to case management as appropriate
Qualifications
Active CA RN license in good standing
2–3 years of clinical experience in prior authorization, case management, or utilization management
Familiarity with InterQual or MCG criteria strongly preferred
Strong critical thinking skills and ability to interpret clinical documentation
Excellent communication abilities with providers and internal teams
Comfort with remote technology, EMRs, and digital workflows
Job Type & Location This is a Contract to Hire position based out of Rancho Cordova, CA. Application Deadline: Jan 6, 2026.
Pay And Benefits The pay range for this position is $40.00 - $50.00/hr. Benefits are subject to change.
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan – Pre‑tax and Roth post‑tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long‑term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)
About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, please email actalentaccommodation@actalentservices.com.
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About the Role We’re looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective patient care from a fully remote environment. This role is ideal for nurses who enjoy clinical evaluation, structured decision‑making, and collaborating with providers to ensure appropriate levels of care.
Key Responsibilities
Conduct utilization reviews for inpatient, outpatient, and ancillary services using established clinical criteria
Assess medical necessity and determine appropriate levels of care
Document clinical findings accurately within internal systems
Communicate with providers to obtain additional clinical information when needed
Support denial management, including appeals and peer‑to‑peer review processes
Ensure regulatory compliance with payer guidelines and organizational policies
Identify care coordination needs and refer cases to case management as appropriate
Qualifications
Active CA RN license in good standing
2–3 years of clinical experience in prior authorization, case management, or utilization management
Familiarity with InterQual or MCG criteria strongly preferred
Strong critical thinking skills and ability to interpret clinical documentation
Excellent communication abilities with providers and internal teams
Comfort with remote technology, EMRs, and digital workflows
Job Type & Location This is a Contract to Hire position based out of Rancho Cordova, CA. Application Deadline: Jan 6, 2026.
Pay And Benefits The pay range for this position is $40.00 - $50.00/hr. Benefits are subject to change.
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan – Pre‑tax and Roth post‑tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long‑term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)
About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, please email actalentaccommodation@actalentservices.com.
#J-18808-Ljbffr