Registered Nurse II/III/IV - QI Inpatient Program

Riverside University Health System (RUHS) - Behavioral Health is currently recruiting for a Registered Nurse II/III/IV to support the Quality Improvement (QI) Inpatient Program.

This recruitment will fill a Registered Nurse vacancy located in Riverside.

Duties may include, but are not limited to:


* Reviewing medical records to determine medical necessity for inpatient hospitalizations


* Liaising and communicating with inpatient hospitals and clinical teams

The ideal candidate will possess:


* Experience with Utilization Review


* Inpatient clinical experience


* Strong proficiency navigating several Electronic Medical Records simultaneously



* Working knowledge of Microsoft office (word, excel and outlook)



* Ability to type a minimum of 40 words per minute



* Excellent communication and organizational skills

Prior experience working in psychiatric/behavioral health settings is essential.

Work Schedule:


* 9/80 schedule


* Some weekends may be required

Meet the Team! Riverside University Health System - Behavioral Health is a leading provider of mental health and substance use services in Riverside County.

With a dedicated team of professionals, including psychiatrists, clinicians, peer specialists, and paraprofessionals, RUHS-BH serves over 45,000 individuals annually.
We are committed to delivering culturally competent, evidence-based care across all ages.

Our programs, including Mental Health Services, Substance Use Services, and the Public Guardian's Office, address the diverse needs of our community.

At RUHS Behavioral Health, you'll join a compassionate, innovative team where your skills make a real difference.

We offer opportunities for growth, collaboration, and meaningful impact.

If you're passionate about advancing your career while improving mental health in Riverside County, RUHS Behavioral Health is the place for you!
For more information, please visit www.ruhealth.org/behavioral-health


* Review the clinical records of patients admitted to psychiatric inpatient facilities to determine if the documentation adequately supports medical necessity.


* Must have an in-depth knowledge of what symptoms, behaviors, factors and documentation meet the standards of medical necessity as defined by Title 9, Medi-Cal, the California Department of Health Care Services (DHCS) and other relevant regulatory agencies.


* Must be able to recognize and gather all the information needed to make a determination, to synthesize and conceptualize this information, to reference applicable medical necessity standards and to ultimately and independently come to a determination about whether medical necessity is present.


* Must be able to accurately and concisely document the clinical information that does or does not support medical necessity and the reasoning that resulted in the ultimate determination.


* Must learn to recognize instances when (s)he is unable to come to a definitive de...