Remote RN Utilization Management

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $35.00/hr - $37.00/hr Direct message the job poster from The Judge Group. Job Title: Remote Registered Nurse (RN) - Temp to Perm Pay Rate: $36-37/hr Start Date: April 7th Licenses required: Compact AND California AND DC Job Summary: We are seeking experienced Registered Nurses (RNs) for a remote temp-to-perm opportunity. The RN will be responsible for completing quality audits of physician case reviews, supporting the clinical aspects of the review process, and resolving operational issues. This role requires a high level of technical skills and the ability to work with multiple programs concurrently. Responsibilities: Complete quality audits of physician case reviews using national medical guidelines (MCG, Interqual, etc.), evaluating the clinical aspects of cases and auditing for accuracy and completeness. Format reviews in accordance with specific formatting requirements. Support the clinical aspects of the review process. Resolve operational issues related to the clinical aspects of review cases. Communicate with assigned reviewers and treating/ordering practitioners/providers. Advise and provide guidance to reviewers on the operational aspects of review cases in all categories (i.e., standard, and ERO cases). Collaborate with the Chief Medical Director and Director of Provider Relations to address reviewer quality issues and support the Provider Relations assessment process. Maintain or exceed the established monthly production benchmark. Qualifications: Must have a compact/multistate license AND a CA single state AND a DC single state. Minimum 3 years of RN experience in a clinical setting with a preference for a broad scope of practice. Hospital bedside nursing experience in ICU, ER, Med/Surg, or Dialysis is required. Backgrounds limited to OR, Peds, L&D, Women’s services, etc., are not preferred. No travel RNs unless they have a stable work history (3+ years at the same facility) either prior to or after their travel assignments. No NPs, whether practicing or not. Utilization Review experience is helpful but not required; critical thinking skills are more important. Proficiency with computers is essential. Candidates will use three monitors (laptop and 2 additional screens) and multiple web-based systems with multiple passwords, as well as Teams, Outlook, and some data entry in Excel. Experience with Milliman or Interqual is a plus. Candidates should not need any extended time off during the first three months of training (approximately 2 months). Schedule: Monday – Friday, 8:00 AM – 4:30 PM MT, with rotating weekends (approximately one weekend every 6 weeks). Comp days will be provided during the week when working the weekend. Additional Information: Equipment will be provided. Seniority level Not Applicable Employment type Full-time Job function Health Care Provider and Administrative Industries Business Consulting and Services and Hospitals and Health Care #J-18808-Ljbffr The Judge Group