Remote Registered Nurse - Utilization Review - RRNUR 26-10215

Job Description

Job Description

Remote Registered Nurse – Utilization Review

Location: Fort Myers, FL 33916
Work Arrangement: Remote
Duration: Contract - 13 Weeks
Schedule: Monday–Friday, 8:00 AM–4:30 PM
Weekend: Every 5th weekend rotation
Radius Requirement: 50-mile radius rule applies — travelers only

Position Overview

We are seeking an experienced Registered Nurse – Utilization Review for a remote Utilization Management position. The ideal candidate will have strong provider-side Utilization Management experience , along with hands-on experience using Dragonfly and Epic .

This role requires an experienced RN who can independently perform utilization review activities in a remote environment and effectively collaborate with providers and healthcare teams.

Key Responsibilities

• Perform Utilization Review and Utilization Management activities in a provider-side healthcare environment.
• Review clinical documentation to determine medical necessity and appropriate levels of care.
• Apply established clinical criteria, policies, and guidelines to utilization decisions.
• Collaborate with providers, physicians, case management teams, and other healthcare professionals.
• Review patient records and clinical information using Epic EMR .
• Utilize Dragonfly for utilization management activities.
• Identify potential gaps in care and escalate issues appropriately.
• Maintain accurate and timely documentation of utilization review activities.
• Communicate effectively with clinical and administrative teams.
• Support organizational quality, compliance, and utilization management objectives.
• Float to sister campuses when required.

Required Qualifications

• Active Registered Nurse (RN) license .
• Minimum 2 years of relevant experience .
• Provider-side Utilization Management experience required.
  • Payer-only Utilization Management experience does not qualify.
• Dragonfly experience required.
• Epic EMR experience required.
• CCM or CMCN certification required.
• Strong clinical assessment, analytical, and documentation skills.
• Comfortable working independently in a remote environment.
• Strong computer skills and ability to work effectively with remote technology.
• Must have access to a personal computer/laptop ; equipment is not provided.
• Prior travel nursing experience highly preferred.
• Degree accreditation verification required, or 5 years of qualifying experience .

Additional Requirements

• Must be willing to participate in an every 5th weekend rotation .
• Must meet the 50-mile radius rule and qualify as a traveler.
• Floating to sister campuses may be required.
• Must be comfortable working remotely with minimal supervision.
• Excellent communication and organizational skills required.