Pacer Staffing is seeking experienced Utilization Management Nurses to join a leading healthcare organization supporting Medicare members. This is a Contract-to-Hire role with long-term potential and strong team collaboration.
Position Details:
• Location: Hybrid – California (Must be local & available onsite as needed)
• Schedule: Mon–Fri, 8 AM – 5 PM PST
• Duration: 6+ months with potential extension & conversion
• Max Pay Rate: $53/hr (W2 pay available)
• Start Date: November 2025
• Department: Utilization Management / Clinical Operations
Key Responsibilities:
• Perform prospective, concurrent, and retrospective utilization reviews
• Apply CMS and nationally recognized clinical criteria to determine medical necessity
• Support discharge planning and post-acute care coordination
• Conduct clinical review of claims for compliance and coding accuracy
• Present cases to Medical Directors for determinations
• Maintain productivity and compliance standards
• Collaborate with Case Management, Behavioral Health, Prior Auth, and Intake teams
Required Qualifications:
• Active RN license
• Minimum 5+ years direct patient care experience
• Excellent communication, documentation & computer navigation skills
• Strong clinical judgment and critical thinking
Preferred Experience:
• UM/UR experience with MCG
• ER and/or ICU background
• Medicare experience
• Bachelor’s Degree in Nursing (preferred)
Work Environment:
• Team size: 12
• Standard laptop and tools provided
• Occasional onsite meetings required
...editorial experience (content strategist, technical writer, editor, etc.). Interest or background in AI, machine learning, or creative tech tools. Compensation and benefits Earn up to $15 USD/hr, paid out weekly Rates vary based on quality, accuracy, and time...
...Urgent Requirements: Company :- Rentomojo Position:- AC Technician Experience:- Min 1 - 2 years Location:- Bangalore Salary:- 25500rs. in hand + PF + ESIC + petrol allowance Must required :- Aadhar card & Pan Card, Smart Phone. Interested...
...Postdoctoral Research Fellow - Nurturing Resilience Initiative/TCHATT The Department of Psychiatry and Behavioral Sciences at The University of Texas Health Science Center (UTHealth Houston... ...publications describing results. # Assists in training and mentoring of lab...
...Dynamics 365 Business Central Consultant Nashville, TN Full-Time About the Role My client is seeking an experienced Dynamics 365 Business Central Consultant with a strong background in Finance and Manufacturing to join their team. This role involves working...
...pulling materials and preparing orders for delivery or pick up. The Driver is also responsible for the safe operation of a commercial... ...the capabilities of a large firm while maintaining the personalized service of a small firm. Today, the company ranks among the nation...