Judge healthcare is seeking a Concurrent Stay Review Nurse (Remote – California) for a great client!

Location: Remote (California-based only), with possible onsite requirements for onboarding or training

Schedule: Monday–Friday, 8:00 AM – 5:00 PM (PST)

Pay: $40-$45/hr based on location in CA

Overview: As a Concurrent Stay Review Nurse, you’ll apply expert clinical knowledge and critical thinking to assess complex medical cases, determine medical necessity, and support quality care delivery. This role involves close collaboration with providers and internal teams to ensure patient care aligns with clinical guidelines and health plan benefits.

Key Responsibilities

• Evaluate detailed patient cases using nursing judgment to determine care appropriateness
• Apply clinical guidelines and policies to assess medical necessity
• Collaborate with providers to enhance patient outcomes and ensure efficient use of resources
• Identify care gaps and recommend alternate treatments, levels, or settings
• Consult with Medical Directors on complex or ambiguous cases
• Support safe discharges through coordination with case management nurses
• Mentor lower-level clinicians and serve as a nursing resource
• Participate in internal projects, training initiatives, and quality improvement efforts
• Conduct audits and contribute to action planning and process refinement
  
  

Qualifications

• Associate Degree in Nursing (Bachelor’s preferred)
• Active, unrestricted CA RN license required; multi-state licensure preferred
• Minimum 4 years of care or case management experience
• Minimum 2 years of clinical, utilization review, or managed care experience
• Deep understanding of complex clinical conditions and healthcare terminology
• Familiarity with healthcare regulations, including Medicare/Medicaid compliance
  
  

Ready to make a meaningful impact from anywhere in California? We're looking for compassionate, driven nurses who thrive on solving complex care challenges and improving lives. If you're ready to elevate your clinical skills while enjoying the flexibility of remote work, apply today and be part of something extraordinary!

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