Remote RN: Utilization Management – Physical Health
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Benefits offered by this job
Job summary
Trillium Health Resources is seeking a qualified Utilization Management Nurse to join the remote team serving North Carolina. The role performs clinical reviews, determines medical necessity, and coordinates care to support effective transitions.
You will collaborate with providers, assist in discharge planning, and monitor ongoing care needs, with typical hours 8:30 am – 5:00 pm and opportunities for remote eligibility and professional growth.
Qualifications
- Associates degree in Nursing; 2 years Utilization Management/Review (ER/ICU/Med-Surg) experience.
- Active North Carolina RN licensure.
- Valid driver's license; travel within catchment allowed.
Responsibilities
- ConductProspective, concurrent, and retrospective clinical reviews using established criteria.
- Assess clinical information to determine medical necessity and level of care.
- Collaborate with providers and facilities to support treatment planning and discharge coordination.
- Perform admission and concurrent reviews to monitor ongoing care needs.
- Identify cases requiring physician review and present clinical recommendations.
Skills
Education
Job description
Trillium Health Resources is seeking a qualified Utilization Management Nurse to join the remote team serving North Carolina. The role performs clinical reviews, determines medical necessity, and coordinates care to support effective transitions.
You will collaborate with providers, assist in discharge planning, and monitor ongoing care needs, with typical hours 8:30 am – 5:00 pm and opportunities for remote eligibility and professional growth.
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