Hybrid RN: Care Coordination & Utilization Review

P3 Health Partners, Inc.; Salem (OR); Hybrid; USD 90,000 - 100,000; Full time

Job summary

P3 Health Partners, Inc. in Salem, OR is seeking a Concurrent Review RN to ensure patients receive appropriate care across the continuum. You will collaborate with hospitals, physicians, care teams, and health plan partners to support utilization management and transitions of care.

The role emphasizes evidence-based decision making, documentation, and multidisciplinary teamwork. Hybrid schedule with in-office three days per week and a salary between $90,000 and $100,000.

Qualifications

• Must hold active RN license in Oregon.
• Minimum 4 years clinical nursing experience.
• 2+ years in managed care, Medicare Advantage, or HMO.
• Experience conducting medical necessity reviews with evidence-based guidelines.

Responsibilities

• Conduct telephonic and onsite utilization reviews including prior authorization and concurrent review.
• Review services within authority and escalate complex cases as needed.
• Apply evidence-based criteria (InterQual, MCG, CMS).
• Coordinate care transitions with hospitals, physicians, and care teams.
• Document reviews and decisions in designated systems.

Skills

Clinical knowledge

Communication

Critical thinking

Office software

Team collaboration

Education

RN education

BSN (preferred)

Tools

InterQual

MCG guidelines

CMS guidelines

Job description

P3 Health Partners, Inc. in Salem, OR is seeking a Concurrent Review RN to ensure patients receive appropriate care across the continuum. You will collaborate with hospitals, physicians, care teams, and health plan partners to support utilization management and transitions of care.

The role emphasizes evidence-based decision making, documentation, and multidisciplinary teamwork. Hybrid schedule with in-office three days per week and a salary between $90,000 and $100,000.