Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with providers and departments to support timely, compliant decisions.
The role requires reviewing both inpatient and outpatient services, familiarity with URAC and NCQA guidelines, and the ability to work independently in a fast-paced managed care environment.
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