Remote Concurrent Review RN - Utilization Management Pro

Pyramid Consulting, Inc; United States; On-site; USD 109,161,000 - 117,482,000; Full time

Benefits offered by this job

Health insurance (medical, dental, and

401(k) plan

Job summary

Pyramid Consulting, Inc. has an immediate need for a Concurrent Review RN for a 6+ month contract located in the United States (Remote). This role centers on medical necessity reviews and ensuring appropriate level of care for inpatient cases.

The RN will perform concurrent reviews, document authorizations, coordinate transitions to SNF, LTACH, inpatient rehabilitation or home health, and collaborate with providers to maintain turnaround times and support quality initiatives.

Qualifications

• RN with state licensure and 2–4 years of related experience.
• Experience in concurrent/continued-stay reviews and utilization management.
• Familiar with InterQual or MCG decision tools.

Responsibilities

• Review inpatient authorization requests to determine medical necessity and level of care.
• Conduct concurrent/continued-stay reviews and document authorizations.
• Coordinate transitions to SNF, LTACH, inpatient rehabilitation, home health, and other post-acute settings.
• Collaborate with providers and interdisciplinary teams; monitor discharge barriers and readmission risks.

Skills

Concurrent Review

Utilization management

Inpatient Acute Care

MCG/InterQual

Education

Bachelor's degree in Nursing

RN Licensure

Job description

Pyramid Consulting, Inc. has an immediate need for a Concurrent Review RN for a 6+ month contract located in the United States (Remote). This role centers on medical necessity reviews and ensuring appropriate level of care for inpatient cases.

The RN will perform concurrent reviews, document authorizations, coordinate transitions to SNF, LTACH, inpatient rehabilitation or home health, and collaborate with providers to maintain turnaround times and support quality initiatives.