Remote Utilization Management RN – Case Review

American Traveler, LLC.; Somerville (MA); Remote; USD 85,000 - 115,000; Full time

Benefits offered by this job

High Pay and Bonuses

Medical, Dental and Vision Insurance

401(k) Plan

Weekly Payroll Deposit

Free Online CEUs

Generous Housing Allowance

Travel and Licensure Reimbursements

Non-taxed Per Diem and Subsidy

Traveler Rewards and Discounts

Job summary

American Traveler is hiring a remote RN for Utilization Management requiring an active MA RN license and prior utilization review and managed care experience.

The role centers on fully remote utilization management with schedules Monday–Friday, 8am–5pm, plus rotating 10-hour shifts including weekends on a rotating basis. InterQual-based decisions, Epic EMR familiarity, and timekeeping via UKG/Kronos are part of daily duties. Local candidates near Boston may receive a reduced rate.

Qualifications

• Active MA RN license required with no pending licenses
• 2-4 years of Utilization Management experience
• 2-4 years of Managed Care experience
• Experience with Medicaid, Medicare, and Commercial lines of business required
• Flu vaccination required with no exemptions allowed

Responsibilities

• Fully remote Utilization Management position
• Most schedules are Monday to Friday, 8am-5pm with no weekends or holidays
• One schedule rotates Friday, Saturday, Sunday, Monday with 10-hour shifts
• Uses InterQual for utilization review decisions
• Epic EMR preferred
• Conduct utilization review and management functions across multiple lines of business
• Local candidates residing within 60 miles of Boston are accepted at a reduced rate
• Time keeping is managed through UKG/Kronos

Skills

Utilization Management

Managed Care

Utilization review experience

Time management

Education

MA RN license

Tools

Epic EMR

InterQual

UKG/Kronos

Job description

American Traveler is hiring a remote RN for Utilization Management requiring an active MA RN license and prior utilization review and managed care experience.

The role centers on fully remote utilization management with schedules Monday–Friday, 8am–5pm, plus rotating 10-hour shifts including weekends on a rotating basis. InterQual-based decisions, Epic EMR familiarity, and timekeeping via UKG/Kronos are part of daily duties. Local candidates near Boston may receive a reduced rate.