Travel RN - Case Management/Utilization Review - Utilization Review

Travel RN - Case Management/Utilization Review

American Traveler

Austin, Texas, United States

Position ID: P-756324

Position status: On Hold

Assignment type: travel

Shift: Days

Length (weeks): 13

Openings: 1

Start date: 2026-11-03

$1,759.50/week (estimated advertised weekly pay)

Description

American Traveler is hiring a remote Utilization Management RN with a TX or compact license and 2 years of acute care UM experience.

Details

• Fully remote position supporting a centralized Utilization Management department
• Oversees acute admission utilization review across 13 acute care and critical access hospitals
• Schedule runs 08:30-17:00
• Uses Cerner with Careport (Allscripts) EMR

Requirements

• Active RN license (TX or compact) required
• 2 years of acute care Utilization Management experience or equivalent required
• BLS certification (AHA) required
• Proficiency with InterQual/MCG and CMS regulations required
• Experience with payor portals, managed Medicare/Medicaid insurers, and Google Workspace preferred
• Remote work experience preferred
• Proficient and adaptable with multiple technologies simultaneously

Additional Information

• Reviews admissions and service requests for prospective, concurrent, and retrospective medical necessity and reimbursement compliance
• Provides case management and consultation for complex cases
• Assists staff with coding, medical records/documentation, precertification, reimbursement, and claims denials/appeals
• Assesses and coordinates discharge planning needs with the healthcare team
• May prepare statistical analysis and utilization review reports
• Oversees compliance with federally mandated and third-party payer UM rules and regulations
• Requires critical thinking, decisive judgment, and the ability to work independently in a stressful environment
• Local candidates accepted, though a radius rule may apply at a reduced rate
• First-time travelers may be considered

Hours per week: 40

Hours per shift: 8