Part-Time Utilization Management RN

IntePros; Pennsylvania; Remote; USD 30,000 - 45,000; Part time

Job summary

IntePros is seeking a Part-Time Utilization Management Registered Nurse (RN) to conduct telephonic reviews of inpatient admissions. This fully remote role requires strong clinical assessment skills and effective communication to ensure high-quality healthcare delivery. Ideal candidates will have a background in utilization management and a commitment to patient care.

Qualifications

• Minimum of 3 years clinical experience in acute care hospital setting.
• Prior experience in utilization management and/or discharge planning.

Responsibilities

• Conduct telephonic utilization reviews of inpatient admissions.
• Collaborate with physicians and hospital departments for care coordination.
• Ensure compliance with regulatory and accreditation standards.

Skills

Communication

Assessment

Organizational Skills

Teamwork

Education

Registered Nurse

BSN

Tools

Medical Software

Electronic Documentation Systems

Job description

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Schedule: Saturdays, 9:00 AM – 5:00 PM (Mandatory weekday training prior to start)

Location: Fully Remote

Employment Type: Part-Time

We are actively seeking a Part-Time Utilization Management Registered Nurse (RN) to join our team. This role is ideal for an experienced RN with a background in utilization review who is looking for consistent weekend work in a fully remote setting.

Position Summary:

Under the direction of a designated Manager, the Utilization Management RN performs telephonic reviews of inpatient hospital admissions, evaluating the medical necessity of continued stays and identifying opportunities for timely discharge planning. This role plays a vital part in promoting high-quality, cost-effective healthcare and facilitating optimal transitions of care.

Key Responsibilities:

• Conduct telephonic utilization reviews of inpatient admissions using established criteria.
• Assess medical necessity for inpatient and continued stay; recommend alternative levels of care when appropriate.
• Collaborate with attending physicians, hospital utilization departments, and discharge planners to support care coordination.
• Refer cases to Medical Directors when admissions do not meet criteria.
• Support early identification of discharge planning needs and help coordinate transitions to home or alternative settings.
• Refer patients to Case Management or Disease Management as needed.
• Identify quality of care concerns and refer to Quality Management when applicable.
• Ensure timely and accurate documentation in compliance with regulatory and accreditation standards.
• Provide outstanding customer service and contribute to ongoing provider education.
• Participate in reporting and trend analysis for utilization patterns or issues.

Qualifications:

• Education: Registered Nurse required; BSN preferred.
• Experience: Minimum of 3 years of clinical experience in an acute care hospital setting.
• Required Background: Prior experience in utilization management and/or discharge planning.

Skills and Competencies:

• Strong verbal and written communication skills
• Ability to assess complex clinical situations and recommend appropriate levels of care
• Proficiency with medical software and electronic documentation systems
• Exceptional organizational and time management skills
• Collaborative, team-oriented approach with a customer-service mindset

Seniority level

• Associate

Employment type

• Part-time

Job function

• Healthcare Provider, Consulting, and Related Fields

Industries

• Hospitals and Healthcare, Insurance, and Information Services