Remote RN Utilization Management

The Judge Group; United States; Remote; Full time

Job summary

An established industry player is looking for experienced Registered Nurses for a remote temp-to-perm role. This position involves conducting quality audits of physician case reviews, ensuring accuracy and compliance with medical guidelines. The ideal candidate will possess strong technical skills, the ability to manage multiple programs, and a commitment to maintaining high standards of patient care. With a focus on collaboration and communication, this role offers a unique opportunity to make a significant impact in healthcare while enjoying a flexible work environment. If you are passionate about nursing and eager to contribute to quality improvement, this role is perfect for you.

Benefits

Equipment provided

Flexible schedule

Comp days for weekend work

Qualifications

• Must have compact/multistate license and CA/DC single state licenses.
• Minimum 3 years of RN experience in a clinical setting required.

Responsibilities

• Complete quality audits of physician case reviews and evaluate clinical aspects.
• Support clinical review processes and resolve operational issues.

Skills

Critical Thinking

Clinical Auditing

Communication

Computer Proficiency

Education

Registered Nurse License

3+ years RN experience

Tools

Microsoft Teams

Microsoft Outlook

Excel

Job description

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This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$35.00/hr - $37.00/hr

Direct message the job poster from The Judge Group.

Job Title: Remote Registered Nurse (RN) - Temp to Perm

Pay Rate: $36-37/hr

Start Date: April 7th

Licenses required: Compact AND California AND DC

Job Summary: We are seeking experienced Registered Nurses (RNs) for a remote temp-to-perm opportunity. The RN will be responsible for completing quality audits of physician case reviews, supporting the clinical aspects of the review process, and resolving operational issues. This role requires a high level of technical skills and the ability to work with multiple programs concurrently.

Responsibilities:

• Complete quality audits of physician case reviews using national medical guidelines (MCG, Interqual, etc.), evaluating the clinical aspects of cases and auditing for accuracy and completeness.
• Format reviews in accordance with specific formatting requirements.
• Support the clinical aspects of the review process.
• Resolve operational issues related to the clinical aspects of review cases.
• Communicate with assigned reviewers and treating/ordering practitioners/providers.
• Advise and provide guidance to reviewers on the operational aspects of review cases in all categories (i.e., standard, and ERO cases).
• Collaborate with the Chief Medical Director and Director of Provider Relations to address reviewer quality issues and support the Provider Relations assessment process.
• Maintain or exceed the established monthly production benchmark.

Qualifications:

• Must have a compact/multistate license AND a CA single state AND a DC single state.
• Minimum 3 years of RN experience in a clinical setting with a preference for a broad scope of practice.
• Hospital bedside nursing experience in ICU, ER, Med/Surg, or Dialysis is required. Backgrounds limited to OR, Peds, L&D, Women’s services, etc., are not preferred.
• No travel RNs unless they have a stable work history (3+ years at the same facility) either prior to or after their travel assignments.
• No NPs, whether practicing or not.
• Utilization Review experience is helpful but not required; critical thinking skills are more important.
• Proficiency with computers is essential. Candidates will use three monitors (laptop and 2 additional screens) and multiple web-based systems with multiple passwords, as well as Teams, Outlook, and some data entry in Excel.
• Experience with Milliman or Interqual is a plus.
• Candidates should not need any extended time off during the first three months of training (approximately 2 months).

Schedule:

• Monday – Friday, 8:00 AM – 4:30 PM MT, with rotating weekends (approximately one weekend every 6 weeks). Comp days will be provided during the week when working the weekend.

Additional Information:

• Equipment will be provided.

Seniority level

Not Applicable

Employment type

Full-time

Job function

Health Care Provider and Administrative

Industries

Business Consulting and Services and Hospitals and Health Care