Remote Utilization Review Nurse

Actalent; Fort Lauderdale (FL); Remote; USD 80,000 - 100,000; Full time

Job summary

A healthcare services provider is seeking a remote Registered Dietitian to provide education and support for members with Diabetes and Congestive Heart Failure (CHF). The role involves developing dietary plans, engaging members through telephonic and digital outreach, and collaborating with community resources. A Bachelor's degree in a health-related field and an active RD license are required. Compensation ranges from $32.00 to $33.00 per hour.

Benefits

Medical, dental & vision benefits

401(k) Retirement Plan

Critical Illness insurance

Qualifications

• Minimum 2 years of disease-specific education experience.
• Current, active, and unrestricted Registered Dietitian (RD) license.

Responsibilities

• Deliver telephonic and digital outreach to engage members.
• Educate members on dietary practices for chronic conditions.
• Develop dietary plans to support self-management.
• Collaborate with Community Resource Coordinators.

Skills

Telephonic outreach

Digital engagement

Dietary education

Chronic conditions knowledge

Education

Bachelor’s Degree in a health-related field

Job description

The Registered Dietitian will provide clinical education and support for Ambetter members enrolled in Disease Management programs, with a focus on Diabetes and Congestive Heart Failure (CHF).

This role is part of an enhanced Diabetes program and a newly launched CHF initiative aligned with Ambetter’s condition-specific products for 2025 and 2026.

Key Responsibilities:

• Deliver telephonic and digital outreach to engage members in care management programs.
• Educate members on dietary practices tailored to chronic conditions including anxiety, asthma, COPD, CHF, depression, and diabetes.
• Develop and guide members through clinically indicated dietary plans to support self-management and treatment goals.
• Collaborate with Community Resource Coordinators and market-level partners to ensure comprehensive support.
• Maintain member engagement for an average of 90–120 days per enrollment cycle.
• Document interactions and progress in accordance with program protocols and compliance standards.

Qualifications:

• Education: Bachelor’s Degree in a health-related field (required).
• Experience: Minimum 2 years of disease-specific education experience (required).
• Licensure: Current, active, and unrestricted Registered Dietitian (RD) license (required).

Program Overview:

• Supports high-risk Diabetes and CHF members as part of the Quality Assurance Initiative (QAI) for 2025–2026.
• Operates regionally to serve all Ambetter markets.
• Offers Core Care Management and specialty programs including Chronic Conditions Programs.
• Backed by a non-clinical support team and market-level partnerships.

Work Environment: Remote Work

Pay and Benefits: The pay range for this position is $32.00 - $33.00/hr. Benefits may include medical, dental & vision, Critical Illness, Accident, and Hospital, 401(k) Retirement Plan, and more.

Actalent is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.