Registered Nurse - Utilization Review - MS26-11799

Job Description

Job Description

Registered Nurse (RN) – Utilization Review

Location: Fort Myers, FL 33916 – Remote
Contract: 13 Weeks
Pay Rate: $45–$50/hr
Hours: 40 Hours/Week
Schedule: Monday–Friday | 8:00 AM–4:30 PM
Weekend: Every 5th weekend rotation
Duration: 13 Weeks | High possibility of extension or permanent placement

Requirements

• Active RN License

• CCM or CMCN certification required

• Epic experience required

• DragonFly Utilization Management experience required

• Provider-side healthcare experience required

• Payer-only experience does not meet the requirement

• Prior travel nursing experience highly preferred

• Strong clinical judgment and computer skills

• Ability to work independently in a remote environment

• Nursing degree from an accredited institution

• Degree accreditation verification required

• If degree accreditation cannot be verified, 5+ years relevant experience required

• RN license number required at submission

Responsibilities

• Perform utilization management and clinical reviews.

• Review patient records, clinical documentation, and treatment plans.

• Determine medical necessity and appropriate level of care.

• Collaborate with providers and healthcare teams regarding utilization decisions.

• Use Epic EMR and DragonFly UM for reviews and documentation.

• Communicate with providers regarding authorization and utilization matters.

• Complete reviews accurately within required timeframes.

• Support appropriate resource utilization and clinical guidelines.

• Maintain accurate and timely electronic documentation.

• Float to other campuses when required; travelers are first to float.

Additional Requirements

• Candidate must meet the applicable 50-mile radius rule from permanent address.

• All RTO must be submitted with the initial profile.

• Must be willing to float as required.