Remote Inpatient Utilization Review RN

WellSense Health Plan in the United States is seeking an Inpatient Utilization Management Clinician to evaluate inpatient medical necessity, monitor treatment, and support discharge planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience with InterQual guidelines and managed care.

You will collaborate with physicians and care management to ensure timely reviews, document outcomes, and maintain regulatory compliance.