Part-Time Utilization Management RN

Capital Markets Placement; Pennsylvania; Remote; USD 10,000 - 60,000; Part time

Job summary

A leading healthcare organization is seeking a Part-Time Utilization Management Registered Nurse (RN) for remote work on Saturdays. The ideal candidate will have experience in utilization review and a strong clinical background to ensure high-quality patient care and efficient discharge planning.

Qualifications

• Minimum of 3 years of clinical experience in an acute care hospital setting.
• Active RN license in good standing.
• Prior experience in utilization management and/or discharge planning.

Responsibilities

• Conduct telephonic utilization reviews of inpatient admissions.
• Assess medical necessity for inpatient and continued stay.
• Collaborate with physicians and discharge planners for care coordination.

Skills

Communication

Clinical Assessment

Organizational Skills

Customer Service

Education

Registered Nurse

BSN preferred

Tools

Medical Software

Job description

IntePros is looking for Part-Time Utilization Management RN in Philadelphia, PA.
This local job opportunity with ID 3201303566 is live since 2025-05-23 22:50:00.

Part-Time Utilization Management RN (Remote – Saturdays Only)

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.
• Licensure: Active RN license in good standing.

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