Remote Utilization Review Nurse – Case Management

IntePros; United States; Remote; USD 48,216 - 61,992; Part time

Job summary

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet patient needs. Candidates must possess a nursing license and have experience in utilization review or home health. This contract role offers a chance to manage healthcare quality efficiently while working remotely.

Qualifications

• Minimum 2 years of general nursing experience in medical, surgical, or critical care.
• At least 1 year of utilization review/management or home health experience required.
• Current nursing license in good standing through applicable state boards.

Responsibilities

• Process patient prior authorization and reauthorization requests.
• Review provider documentation for continued home health services.
• Collaborate with provider staff and care teams for patient needs.

Skills

Organizational skills

Attention to detail

Communication skills

Time management

Knowledge of home care regulations

Familiarity with home health services

Education

Graduate of an accredited professional nursing program (RN, LPN, or LVN)

Tools

MS Office (Outlook, Excel, Word, Adobe)

EMR and case management systems

Job description

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet patient needs. Candidates must possess a nursing license and have experience in utilization review or home health. This contract role offers a chance to manage healthcare quality efficiently while working remotely.