Registered Nurse - Utilization Review - RNUR 26-10215

Job Description

Job Description

Job Title: Registered Nurse – Utilization Review

Job Location: Fort Myers, FL

Work Arrangement: Remote

Duration: 13 Weeks

Compensation: $1,900–$2,100 Gross Weekly (Based on Experience)

Shift: Day Shift

Schedule:

• Monday–Friday
• 8:00 AM – 4:30 PM
• 40 Hours Per Week

Position Type: Contract

Work Setting: Remote

Position Overview

We are seeking an experienced Registered Nurse (RN) – Utilization Review/Utilization Management for a 13-week remote contract assignment. The RN will review clinical information and medical records to support appropriate levels of care, medical necessity, resource utilization, and positive patient outcomes.

The ideal candidate will have provider-side utilization management experience , strong clinical judgment, excellent computer skills, and hands-on experience with Epic and DragonFly . Candidates must be comfortable working independently in a remote environment while maintaining productivity, accuracy, and quality standards.

Responsibilities

• Perform utilization review and utilization management activities.
• Review patient medical records, clinical documentation, and treatment information.
• Assess medical necessity and appropriateness of level of care.
• Collaborate with healthcare providers regarding patient care and utilization needs.
• Communicate effectively with providers and members of the interdisciplinary care team.
• Utilize DragonFly as the primary utilization management platform.
• Accurately and promptly document utilization reviews and clinical determinations.
• Navigate and document within the Epic EMR .
• Support appropriate resource utilization and optimal patient outcomes.
• Work independently in a remote environment while meeting productivity and quality expectations.
• Float to other affiliated campuses as required based on staffing needs; travelers may be expected to float first when coverage is needed.
• Perform other utilization management duties as assigned.

Required Qualifications Licensure

• Active Registered Nurse (RN) license required.

Experience

• Minimum 2 years of relevant nursing experience .
• Provider-side utilization management experience required.
• Candidates with exclusively payer-side utilization management experience do not meet the requirement.
• Previous remote-work experience preferred.
• Prior travel nursing experience highly preferred.

Technical Skills

• DragonFly experience required.
• Epic EMR experience required.
• Strong computer literacy and clinical documentation skills.
• Ability to efficiently navigate multiple electronic systems while working remotely.

Certifications

• CCM or CMCN certification required.

Education

• Degree accreditation must be verified, or candidate must have at least 5 years of relevant experience .