Remote RN - Clinical Access & Utilization Review

Santa Barbara Cottage Hospital; United States; Remote; USD 55,000 - 83,000; Part time

Benefits offered by this job

Health, dental and vision benefits

Tuition reimbursement

401(k) with company contributions

Paid time off

Job summary

Geisinger, a nationally recognized health system, seeks an experienced RN to join our per diem utilization management team from home in Pennsylvania. The role supports medical necessity reviews and level of care determinations.

You will review cases, ensure documentation accuracy, and collaborate with care teams to optimize patient outcomes. Requires at least 3 years of RN experience and preferably UM background.

Qualifications

• Minimum of 3 years RN experience.
• Prior Utilization Management experience preferred.
• Experience in an acute care setting is preferred.
• BSN preferred.

Responsibilities

• Perform utilization management chart reviews for medical necessity and level of care.
• Determine appropriate level of care and review documentation for compliance.
• Enter utilization review data into the tracking/database system.
• Collaborate with care teams to provide information and alternatives and ensure documentation integrity.

Skills

RN experience

Utilization Management

Acute care experience

Education

RN license (PA)

BSN preferred

Job description

Geisinger, a nationally recognized health system, seeks an experienced RN to join our per diem utilization management team from home in Pennsylvania. The role supports medical necessity reviews and level of care determinations.

You will review cases, ensure documentation accuracy, and collaborate with care teams to optimize patient outcomes. Requires at least 3 years of RN experience and preferably UM background.