Remote Utilization Review Nurse - Weekend PRN

Brundage Group; Town of Florida (NY); Hybrid; USD 55,000 - 83,000; Full time

Job summary

Brundage Group is seeking a Utilization Review Nurse for a PRN weekend shift in a fully remote Florida role. The UR Nurse reviews admissions and continued stays to ensure medical necessity and payer compliance, collaborating with physicians and case managers to optimize reimbursement while supporting patient care.

Candidates must have an active RN license, five years of acute care nursing, two years UR experience, and BSN preferred.

Qualifications

• Minimum five (5) years of acute care nursing experience in a hospital setting.
• Minimum two (2) years of hospital-based or health plan utilization review experience
• Graduate of an accredited school of nursing; RN license active
• BSN: preferred; CCM/ACM/CMGT-BC certifications preferred

Responsibilities

• Perform hospital admission reviews to determine medical necessity and appropriate patient status.
• Conduct continued stay reviews using approved clinical criteria and guidelines.
• Evaluate documentation for accuracy and payer/regulatory compliance.
• Communicate review findings to physicians and care management teams.
• Collaborate with Physician Advisors on complex cases.
• Assist with denial prevention and accurate documentation.
• Proficient in multiple EHR and case management systems.

Skills

Strong communication

Independent worker

Fast-paced environment

Attention to detail

Education

BSN preferred

RN license

Tools

InterQual

MCG

Electronic Health Records

Job description

Brundage Group is seeking a Utilization Review Nurse for a PRN weekend shift in a fully remote Florida role. The UR Nurse reviews admissions and continued stays to ensure medical necessity and payer compliance, collaborating with physicians and case managers to optimize reimbursement while supporting patient care.

Candidates must have an active RN license, five years of acute care nursing, two years UR experience, and BSN preferred.