Utilization Management RN - Post Acute

IntePros

Utilization Management RN
Remote (Must reside in PA, NJ, or DE)

Overview:
Seeking an experienced Utilization Management RN to support inpatient utilization review and care coordination in a remote environment. This role is responsible for reviewing hospital admissions, determining medical necessity, and helping ensure members receive care in the most appropriate setting while supporting timely discharge planning and efficient use of healthcare resources. Post-acute care experience is required, along with an active Pennsylvania RN license.

Key Responsibilities:

Perform telephonic utilization review for inpatient admissions and continued stays using established clinical criteria.
Evaluate medical necessity and determine appropriate level of care and length of stay.
Collaborate with physicians, hospital utilization review teams, and care management staff to clarify treatment plans.
Identify cases that no longer meet criteria and escalate to Medical Directors for further review when appropriate.
Support early discharge planning and coordinate transitions to appropriate post-acute care settings.
Identify cases for case management or disease management programs.
Maintain accurate documentation and ensure compliance with state, federal, and accreditation regulations.

Qualifications:

Active Pennsylvania RN license required
Minimum 3 years of acute care hospital experience
Post-acute care experience required
Prior utilization management, discharge planning, or case management experience preferred

Skills:

Strong clinical judgment, communication, problem-solving, and organizational skills with the ability to work independently in a remote, high-volume review environment.

#LI-VA1
#LI- Remote

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Utilization Management RN - Post Acute in Philadelphia, PA vacancy

RN-Utilization Review- 40/hrs, Day Shifts (Temple Hospital)
...Utilization Management Nurse Utilizing InterQual and other appropriate criteria, responsible for... ...experience of recent Utilization Review in acute care or in insurance company setting.... ...Certified Case Manager Preferred Multi State Compact RN License Required Or...
Suggested
Night shift
Day shift
IntelyCare
Philadelphia, PA
5 days ago
Part Time Utilization Management RN - Home Health
...Care Management Coordinator (Home Health Team) Remote | Part-Time (18.75 Hours/Week) | PA RN License Required Job Summary The Care Management Coordinator is responsible... ...for review and determination. Utilization Management Utilize resources including...
Suggested
Part time
Remote work
Monday to Friday
Flexible hours
Shift work
IntePros
Philadelphia, PA
3 days ago
RN-Utilization Review- 40/hrs, Day Shifts (Temple Hospital)
...Utilizing InterQual and other appropriate criteria, responsible for reviewing... ...in the hospital's utilization management and quality assurance plan.... ...recent Utilization Review in acute care or in insurance company... ...Multi State Compact RN License Required Or Your Tomorrow...
Suggested
Night shift
Day shift
Temple University
Philadelphia, PA
1 day ago
Travel Nurse RN - Long-Term Acute Care in Philadelphia, PA
...Registered Nurse (RN) | Long-Term Acute Care Location: Philadelphia, PA Agency: Titan Medical Group Pay: Competitive weekly pay (inquire for details) Shift Information: Days - 3 days x 12 hours Contract Duration: 52 Weeks Start Date: 6/29/2...
Suggested
Weekly pay
Daily paid
Full time
Contract work
Shift work
TravelNurseSource
Philadelphia, PA
15 days ago
Travel Nurse RN - Long-Term Acute Care in Philadelphia, PA
...Registered Nurse (RN) | Long-Term Acute Care Location: Philadelphia, PA Agency: Access Healthcare LLC Pay: Competitive weekly pay (inquire for details) Shift Information: Nights - 3 days x 12 hours Contract Duration: 52 Weeks Start Date: 6/...
Suggested
Weekly pay
Daily paid
Permanent employment
Full time
Contract work
Summer work
Shift work
Night shift
3 days per week
TravelNurseSource
Philadelphia, PA
9 days ago
Travel Nurse RN - Long-Term Acute Care in Philadelphia, PA
...Registered Nurse (RN) | Long-Term Acute Care Location: Philadelphia, PA Agency: Access Healthcare LLC Pay: Competitive weekly pay (inquire for details) Shift Information: Nights - 3 days x 12 hours Contract Duration: 52 Weeks Start Date: 6/...
Weekly pay
Full time
Contract work
Summer work
Shift work
Night shift
3 days per week
Access Healthcare LLC
Philadelphia, PA
9 days ago
Travel Nurse RN - Long-Term Acute Care in Philadelphia, PA
...Registered Nurse (RN) | Long-Term Acute Care Location: Philadelphia, PA Agency: Malone Healthcare Pay: Competitive weekly pay (inquire for details) Start Date: ASAP About the Role: Malone Healthcare is seeking a Long-Term Acute Care Registered...
Weekly pay
Full time
Contract work
Summer work
Immediate start
Shift work
Malone Healthcare
Philadelphia, PA
15 days ago
Travel Nurse RN - Long-Term Acute Care in Philadelphia, PA
...Registered Nurse (RN) | Long-Term Acute Care Location: Philadelphia, PA Agency: Titan Medical Group Pay: Competitive weekly pay (inquire for details) Shift Information: Days - 3 days x 12 hours Contract Duration: 52 Weeks Start Date: 6/29/2...
Weekly pay
Daily paid
Full time
Contract work
Shift work
Titan Medical Group
Philadelphia, PA
15 days ago
Travel Nurse RN - Long-Term Acute Care in Philadelphia, PA
...Registered Nurse (RN) | Long-Term Acute Care Location: Philadelphia, PA Agency: Titan Medical Group Pay: Competitive weekly pay (inquire for details) Shift Information: Nights - 3 days x 12 hours Contract Duration: 52 Weeks Start Date: 6/29...
Weekly pay
Daily paid
Full time
Contract work
Shift work
Night shift
Titan Medical Group
Philadelphia, PA
15 days ago
Travel Nurse RN - Long-Term Acute Care in Philadelphia, PA
...Registered Nurse (RN) | Long-Term Acute Care Location: Philadelphia, PA Agency: Malone Healthcare Pay: Competitive weekly pay (inquire for details) Start Date: ASAP About the Role: TravelNurseSource is working with Malone Healthcare to find a...
Weekly pay
Full time
Contract work
Summer work
Immediate start
Shift work
TravelNurseSource
Philadelphia, PA
15 days ago
Travel Nurse RN - Long-Term Acute Care in Philadelphia, PA
...Registered Nurse (RN) | Long-Term Acute Care Location: Philadelphia, PA Agency: Titan Medical Group Pay: Competitive weekly pay (inquire for details) Shift Information: Nights - 3 days x 12 hours Contract Duration: 52 Weeks Start Date: 6/29...
Weekly pay
Daily paid
Full time
Contract work
Shift work
Night shift
TravelNurseSource
Philadelphia, PA
15 days ago
Urgent Care Nurse Coordinator: RN Lead in Acute Care
...a dedicated Registered Nurse for their Urgent Care Center in Audubon, New Jersey. The RN will facilitate comprehensive patient care, ensuring safety and responsiveness to the acute needs of patients. The ideal candidate will have at least 3 years of emergency nursing...
COOPER PEDIATRICS
Audubon, NJ
5 days ago
RN Care Manager - Philadelphia, PA
...Nurse Care Manager ArchWell Health is re-imagining the... ...of patients with acute and chronic conditions,... ...centers into acute and post-acute facilities, as well... ...their health goals. Utilize Motivational Interviewing... ...Degree in Nursing (BSN) or RN with bachelor's degree in...
Work experience placement
Work at office
Remote work
ArchWell Health
Philadelphia, PA
2 days ago
RN Bed Management Coordinator - (Part-time, Day)
$37.21 - $57.68 per hour
Join to apply for the RN Bed Management Coordinator - (Part-time, Day) role at Virtua Health Location... ...bed assignments, ensuring efficient utilization of resources, and supporting patient... ...Minimum of 3 years of nursing experience in acute care settings, with a preference for...
Hourly pay
Full time
Temporary work
Part time
Local area
Remote work
Flexible hours
Shift work
Day shift
Virtua Health
Pennsauken, NJ
2 days ago
RN Case Manager Per Diem - (Temple University Hospital)
...interdisciplinary team, the Case Manager facilitates the patient's progress through the acute episode of care in an efficient... ...care Case Management setting or Utilization Management at an acute care facility... ...Multi State Compact RN License Required Or Your Tomorrow...
Daily paid
Temple University
Philadelphia, PA
4 days ago
RN Care Coordinator
$42 - $45 per hour
...Innova Solutions is immediately hiring an RN Care Coordinator. Position type:... ...Coordinator , you will: Be performing utilization management for inpatient admissions either onsite... ...: Minimum of three (3) years of acute care clinical experience in a hospital...
Hourly pay
Full time
Contract work
Temporary work
Work experience placement
Immediate start
Worldwide
Flexible hours
Innova Solutions
Philadelphia, PA
4 days ago
Lead Case Manager RN
...Lead Case Manager RN The Lead Case Manager RN utilizes advanced nursing skills and knowledge to comprehensively coordinate... ...Planner Knowledge of the patient's post-discharge needs and the ability to... ...patient transfers to other acute care hospitals. ~ Communicates with...
Shift work
Weekend work
Jefferson
Philadelphia, PA
3 days ago
Care Management Coordinator/RN - 100% Remote
...Care Management Coordinator/RN Location: 100% Remote Duration: 3+ Months (Possible FT Conversion... ...eligible for potential conversion. Post acute experience required Must have a PA RN... ...collaborates with the hospital utilization review department, attending physicians...
Remote job
Alpha Business Solutions
Philadelphia, PA
5 days ago
Acute Inpatient Registered Nurse - RN
...professional registered nurse Inpatient RN CAP 2 may be an entry level designation into... ...analysis of patient data pre – during – post treatment for assigned patients and documents... ...requirements. ~6 months experience in acute dialysis as a RN. EDUCATION AND...
Full time
Night shift
Weekend work
Fresenius Medical Care
Philadelphia, PA
3 days ago
Acute Inpatient Registered Nurse - RN
...prior dialysis experience required, we will train! Great for RN's with prior acute experience such as MedSurg. Starbucks onsite and great... ...systematic collection and analysis of patient data pre – during – post treatment for assigned patients and documents in the patient...
Daily paid
Full time
Part time
Shift work
Night shift
Rotating shift
Weekend work
Fresenius Medical Care
Philadelphia, PA
1 day ago
Operating Room RN PRN
...care providers regarding patient care and management; supports efficient and timely... ...in quality improvement opportunities Utilizes evidence-based ambulatory care nursing interventions... ...patients i.e. abnormal results, triage, RN verification of vaccinations and other injections...
Daily paid
Relief
Shift work
Jefferson
Philadelphia, PA
9 days ago
RN Ambulatory (PT-Day, 20hrs/week) - Family Practice Association - Jenkintown, PA
...care providers regarding patient care and management; supports efficient and timely... ...in quality improvement opportunities Utilizes evidence-based ambulatory care nursing interventions... ...patients i.e. abnormal results, triage, RN verification of vaccinations and other injections...
Daily paid
Full time
Temporary work
Part time
Flexible hours
Shift work
Jefferson
Jenkintown, PA
1 day ago
Registered Nurse (RN), per diem
$42.3 per hour
...Registered Nurse (RN) – Men’s Health Clinic | Ageless Men’s Health Location: Upper... ...PA. At Ageless, we focus on medically managed testosterone replacement therapy (TRT), weight... ...clinic environment (wellness care - no acute or sick patients) Opportunities for growth...
Hourly pay
Daily paid
Full time
Monday to Friday
Shift work
Weekend work
Ageless Men's Health
Dresher, PA
3 days ago
Home Care RN PRN
...SUMMARY OF JOB A Home Care Visiting RN provides safe, holistic care to a population... .... The RN educates regarding self management and provides support to meet the needs of... ...a home care setting; able to efficiently utilize technology (cell phone, computer); able to...
Relief
Weekend work
Redeemer Health Home Care & Hospice
Philadelphia, PA
a month ago
RN Clinical Quality Improvement & Patient Safety - Full Time
...Quality Improvement/ Patient Safety RN Position Code: CQPaSafRN-8030 Department: Quality Management Oracle Title: Click here to... ...of project requirements Utilizes quality and safety improvement... ...safety initiatives Supports post-implementation monitoring to validate...
Full time
Temporary work
Kingman Regional Medical Center
Philadelphia, PA
2 days ago
Travel Nurse RN - Wound/Ostomy - $2,338 per week in Philadelphia, PA
$2,338 per week
...Registered Nurse (RN) | Wound/Ostomy Location: Philadelphia, PA Agency... ...in the assessment, treatment, and management of patients with acute or chronic wounds. The RN provides expert... ...and as per facility protocols, utilizing safe and effective methods (e.g., autolytic...
Full time
Contract work
Shift work
Magnet Medical
Philadelphia, PA
8 days ago
Registered Nurse
...prescribes, coordinates, and delegates care utilizing the nursing process which is integrated... ..., limit setting, behavior and crisis management. This opportunity offers the following... ...operating through its subsidiary acute care hospitals, behavioral health facilities...
Part time
Local area
Shift work
Universal Health Services
Philadelphia, PA
2 days ago
School Nurse
...- FLSA Status: Salary The management services offered to our family... ...applicable. Manage and control acute and chronic illnesses.... ...teachers and assists families in utilizing community resources for improving... ...School Nurse or Licensed as RN or LPN. Bachelor's degree in...
Full time
Work at office
Local area
Universal Charter Schools
Philadelphia, PA
1 day ago
RN Weekend Supervisor
$45 - $50 per hour
...RN Weekend Supervisor Join our team at Cambridge Rehabilitation & Healthcare Center as an RN Weekend Supervisor! Proudly supported... ...at Cambridge Rehabilitation and Healthcare Center, a 120-bed Sub-Acute, and Long-Term Care facility where compassion and quality care...
Daily paid
Part time
Local area
Weekend work
Marquis Health Consulting Services
Moorestown, NJ
2 days ago
Divisional Vice President of Resident Care (RN/DON)
$180k - $200k
...About Discovery Management Group Discovery Management Group leads one... ...: Active Registered Nurse (RN) license in good standing.... ...solving skills. Experience utilizing electronic clinical documentation... ...Employment Scam Warning We only post jobs on our official careers...
Full time
Work at office
Local area
Remote work
Discovery Senior Living
Philadelphia, PA
3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Utilization Management RN - Post Acute. Be the first to apply!