Remote RN - Utilization Review & Care Coordination

Lancesoft; United States; Remote; USD 54,000 - 77,000; Full time

Job summary

Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care, and ensure compliance with state and federal regulations.

The role requires an active RN/LPN/LVN license and 2–4 years of clinical experience. Strong InterQual knowledge, problem-solving, and communication skills are essential. Schedule is 8–5 PST, on a W2 hourly rate of $47.37.

Qualifications

• Excellent communication and coordination skills.
• Strong organizational and multitasking abilities.
• Knowledge of state and federal regulations affecting care.
• Familiarity with InterQual guidelines and NCQA considerations.
• Ability to maintain confidentiality and HIPAA compliance.

Responsibilities

• Provide concurrent review and prior authorizations for behavioral health cases.
• Assess benefits, eligibility, and expected length of stay for treatments.
• Collaborate with other departments to ensure continuity of care.
• Maintain productivity and quality metrics for the department.
• Mentor new team members and participate in staff meetings.
• Refer cases to medical directors as needed and ensure compliance.

Skills

Communication

Organization

Multitasking

Problem-solving

HIPAA compliance

Education

Registered Nursing degree

Job description

Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care, and ensure compliance with state and federal regulations.

The role requires an active RN/LPN/LVN license and 2–4 years of clinical experience. Strong InterQual knowledge, problem-solving, and communication skills are essential. Schedule is 8–5 PST, on a W2 hourly rate of $47.37.