Travel Nurse RN - Utilization Review
Hanover, MD
Care Career
5x8 hrs, Days
Referral Bonus

Utilization Review Nurse (Remote)

Location: 100% Remote
Schedule: Monday–Friday | 8:00 AM–5:00 PM EST
No Call | No Weekends | No Holidays
Contract Opportunity

We are seeking an experienced Utilization Review RN for a fully remote opportunity. This is a medical review role with no direct patient care responsibilities.

Requirements:
• Active RN License
• Minimum 5 years of RN experience
• Current Utilization Review experience
• Epic EMR experience
• Proficiency with InterQual criteria
• Managed Care Utilization Review experience preferred
• Must provide own computer/equipment

Responsibilities:
• Perform medical necessity and utilization reviews for acute, sub-acute, and rehabilitation services
• Apply InterQual criteria to determine authorization of services
• Coordinate with Medical Directors regarding approvals and denials
• Initiate discharge planning and coordinate post-discharge services
• Communicate authorization decisions with providers, facilities, and members
• Maintain accurate documentation and quality standards
• Collaborate with interdisciplinary teams to ensure appropriate utilization of healthcare resources

Ideal Background:
• Utilization Review RN
• Utilization Management RN
• Concurrent Review RN
• Managed Care RN
• Health Plan RN
• Case Management RN with strong UR experience

Interested? Apply today!