Overview Guidehouse is a leading global provider of consulting services to the public sector and commercial markets, with broad capabilities in management, technology, and risk consulting. By combining our public and private sector expertise, we help clients address their most complex challenges and navigate significant regulatory pressures focusing on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that help our clients outwit complexity and position them for future growth and success. The company has more than 12,000 professionals in over 50 locations globally. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and diverse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies. For more information, please visit www.guidehouse.com . Responsibilities The Primary responsibilities of the Patient Access Nurse are to facilitate patient medical and financial clearance using nursing knowledge, clinical judgment, and communication skills to assist in resolving difficulties surrounding patient access and authorization of services. The position is a day shift (7:00 AM- 7:00 PM) with rotating weekends at a major hospital facility in South Los Angeles. The ideal candidate will have two or more years’ experience in utilization review with external payors within a hospital or insurance setting. Duties and Responsibilities: * Consistently and accurately utilizes medical acceptance criteria to screen Emergency Room patients in a way to ensure optimal efficiency in the patient Access operations. * Performs clinical review of all inpatients to determine medical acceptance following the Miliman guidelines and communicates with patients, and physicians who fail to meet medical criteria for acceptance. * Uses excellent oral communication and listening skills to communicate with patient, physician and clinical staff regarding obstacles to access or financial clearance. * Responds to voicemails within one business day and answers phone calls in a timely manner. * Completely and accurately documents communications with payors, patients, and the treatment team. Qualifications Required: * Minimum two years’ experience in nursing or one-year related nursing experience in utilization review/insurance/case management/medical clearance. * Experience in Hospital Utilization Management (preferably an acute care hospital). * Graduation from an accredited school of nursing. * Current State of California Professional Nursing License (RN) * Ability to read and comprehend English. * Demonstrates excellent customer service skills. * Highly organized and well developed with strong communication skills, oral and written. * Confidence to communicate and outreach to other community health care organizations and personnel. * Demonstrates sound judgment, decision making and problem-solving skills. * Ability to apply principles of process improvement * Must be able to follow detailed instructions and perform repetitious tasks * Computer/basic keyboard skills, telephone skills, and general knowledge of office machines including printers, fax, copier, scanner, and credit card machines required. Preferred Qualifications: * Two years’ experience in utilization review with external payors within a hospital or insurance setting. * Bachelor of Science in Nursing (BSN). Additional Requirements The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described. Due to our contractual requirements, to be eligible for this role, you must be fully COVID-19 vaccinated at time of hire. Disclaimer About Guidehouse Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee. Rewards and Benefits Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. Benefits include: * Medical, Rx, Dental & Vision Insurance * Personal and Family Sick Time & Company Paid Holidays * Position may be eligible for a discretionary variable incentive bonus * Parental Leave and Adoption Assistance * 401(k) Retirement Plan * Basic Life & Supplemental Life * Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts * Short-Term & Long-Term Disability * Tuition Reimbursement, Personal Development & Learning Opportunities * Skills Development & Certifications * Employee Referral Program * Corporate Sponsored Events & Community Outreach #Indeedsponsored