Remote Utilization Management Specialist (RN/SW)

Applied Health Services, Inc.; United States; Remote; USD 52,000 - 75,000; Full time

Benefits offered by this job

Four day work week

Affordable Medical Benefits package

401(k) with generous immediate company

Fitness Center Membership Discount

Supportive nursing culture

Job summary

Logan Health is seeking a Utilization Management Specialist with acute care experience to review admissions across our system. The role emphasizes collaboration with physicians, case management, and insurance partners to determine status and ensure medical necessity.

The position requires MT licensure (RN) or equivalent, with a strong background in inpatient UM and documentation accuracy. We offer a four-day work week, strong benefits, and a mission-driven culture.

Qualifications

• Current Montana RN License or multi-state compact license with MT authorization.
• Bachelor’s degree in Social Work; Associate’s degree required; Bachelor’s preferred.
• CCM Certification preferred.
• Minimum five years of acute care hospital experience.

Responsibilities

• Review inpatient and observation admissions across the Logan Health system.
• Evaluate documentation and patient data to determine admission status.
• Collaborate with UM Advisor, case management and insurers on authorizations.
• Perform concurrent and retrospective reviews as directed.

Skills

Acute care hospital experience

Inpatient UM experience

Communication skills

Collaboration with physicians

Education

Bachelor’s degree in Social Work

Associate’s degree

Montana RN License

CCM Certification preferred

Job description

Logan Health is seeking a Utilization Management Specialist with acute care experience to review admissions across our system. The role emphasizes collaboration with physicians, case management, and insurance partners to determine status and ensure medical necessity.

The position requires MT licensure (RN) or equivalent, with a strong background in inpatient UM and documentation accuracy. We offer a four-day work week, strong benefits, and a mission-driven culture.