Remote Utilization Nurse (RN/LVN) – Inpatient

Medix™; California; Remote; USD 90,000 - 120,000; Full time

Job summary

Medix is seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) for a 100% remote Utilization Management role in inpatient acute care. Involves discharge planning, concurrent reviews, and post-acute coordination, with a California license required and 5+ years of UM experience preferred.

The position supports a fast-paced, metrics-driven environment and offers a fully remote work arrangement with a contract-to-hire path.

Qualifications

• Active, unrestricted California RN or LVN license.
• 5+ years of concurrent inpatient Utilization Management experience strongly preferred.
• Experience in IPA, MSO, Delegated Medical Group, or Health Plan environments.
• Hands-on experience with MCG Guidelines for inpatient acute care and SNF reviews.
• Experience with discharge planning, denial letter writing, and Medicare guidelines.
• Proficient with Microsoft Office (Excel, Word, PDF).

Responsibilities

• Manage the full Utilization Management process from admission through discharge.
• Perform concurrent inpatient reviews, daily clinical reviews, and discharge planning.
• Coordinate post-acute services including SNF, Home Health, and DME.
• Apply MCG criteria, Medicare guidelines, and medical necessity criteria for reviews.
• Prepare and issue clinical denial letters.
• Present patient cases during rounds and collaborate with physicians and hospital staff.
• Maintain accurate documentation while meeting productivity and quality metrics.

Skills

Clinical judgment

Critical thinking

Communication with physicians

Independent remote work

Productivity focus

Detail-oriented

Tools

Microsoft Office

Job description

Medix is seeking experienced Registered Nurses (RN) or Licensed Vocational Nurses (LVN) for a 100% remote Utilization Management role in inpatient acute care. Involves discharge planning, concurrent reviews, and post-acute coordination, with a California license required and 5+ years of UM experience preferred.

The position supports a fast-paced, metrics-driven environment and offers a fully remote work arrangement with a contract-to-hire path.