Utilization Review Nurse

We're Hiring: Utilization Review Nurse (RN) – 100% Remote Looking for your next opportunity in Utilization Review? If you're an experienced RN with a strong background in utilization review and a passion for evidence-based care, this is your chance to join a mission-driven organization from the comfort of home.The full job description covers all associated skills, previous experience, and any qualifications that applicants are expected to have. Position Details• Role: Utilization Review Nurse (RN)• Type: Contract-to-Hire (eligible after 800 hours)• Location: 100% Remote Schedule Options• Sunday–Thursday or Tuesday - Saturday• 8:30 AM – 5:00 PM or 4x10s• Training: Monday–Friday, 8:30 AM – 5:00 PM (4-5 weeks) What You'll DoReviews current inpatient or ongoing treatment plansChecks medical records, labs, and physician notesCommunicates with doctors, case managers, and care teamsApplies clinical guidelines like MCGDetermines if the level of care (inpatient vs observation) is appropriateRecommends continued stay, discharge, or alternative care settings Required Qualifications• Active, unrestricted RN license (single state or compact/NLC)• Associate or Bachelor's Degree in Nursing (or accredited program graduate)• Experience with MCG guidelines• Ability to obtain additional state licenses if needed• 1+ year of utilization review experience doing concurrent xhyhwjd reviews (managed care)• 1+ year of clinical experience in an acute care setting (ER, hospital, etc.) Preferred Qualifications• BSN• Experience with concurrent or inpatient reviews for a health plan Interested or know someone who is?Apply today or message me directly to learn more!NowHiring #RemoteNursing #UtilizationManagement #NurseJobs #HealthcareCareers #RNJobs #CaseManagement #ManagedCare