Remote Utilization Review Nurse — Inpatient & MCG Expert

Medix Staffing Solutions, Inc.; California; Remote; USD 55,000 - 70,000; Part time

Job summary

Medix Staffing Solutions, Inc. is seeking an experienced California RN or LVN with strong Utilization Management and inpatient review experience for a 100% remote role focused on inpatient clinical review, UM, and discharge planning.

You will apply MCG criteria and Medicare guidelines, coordinate SNF/ARU placements, participate in multidisciplinary rounds, and collaborate with Medical Directors and hospital teams while maintaining a California license.

Qualifications

• Active California RN or LVN license.
• Strong utilization management and inpatient review experience.
• Experience applying MCG criteria and Medicare guidelines.
• Remote work capability and ability to collaborate with hospital teams.

Responsibilities

• Manage the full UM process through discharge planning.
• Apply MCG criteria to clinical reviews.
• Apply LCD/NCD and Medicare guidelines.
• Coordinate complex SNF and ARU placements.
• Participate in multidisciplinary rounds.
• Collaborate with Medical Directors, physicians and hospital teams.

Skills

Utilization management

Inpatient reviews

Multidisciplinary rounds

CMS turnaround timelines

Education

California RN or LVN license

Job description

Medix Staffing Solutions, Inc. is seeking an experienced California RN or LVN with strong Utilization Management and inpatient review experience for a 100% remote role focused on inpatient clinical review, UM, and discharge planning.

You will apply MCG criteria and Medicare guidelines, coordinate SNF/ARU placements, participate in multidisciplinary rounds, and collaborate with Medical Directors and hospital teams while maintaining a California license.