Remote Utilization Management RN — Part-Time (M-F)

HealthCare Strategies; United States; Remote; USD 36,000 - 57,000; Part time

Job summary

HealthCare Strategies is seeking an Utilization Management RN to handle telephonic assessments and medical necessity reviews from a home office. The role supports plan members, educates patients, and determines prior authorization needs during core hours.

Requirements include an active RN license and hospital experience. Strong communication, problem-solving, and MS Office proficiency are needed to document outcomes and coordinate with providers.

Qualifications

• Active, unrestricted RN Compact License.
• Minimum 1+ year experience in hospital setting.
• Strong verbal communication and ability to follow instructions.

Responsibilities

• Perform telephonic Clinical Assessments.
• Obtain information from provider/patient regarding plan.
• Interpret criteria to support inpatient/outpatient service decisions.
• Document calls completely and accurately in the system.

Skills

Strong verbal communication

Problem solving

Decision making

MS Office

Education

RN license

Tools

Outlook

Word

Job description

HealthCare Strategies is seeking an Utilization Management RN to handle telephonic assessments and medical necessity reviews from a home office. The role supports plan members, educates patients, and determines prior authorization needs during core hours.

Requirements include an active RN license and hospital experience. Strong communication, problem-solving, and MS Office proficiency are needed to document outcomes and coordinate with providers.