Remote Utilization Review RN – 6‑Month Contract (TX)

HireOps Staffing; United States; Remote; USD 45,000 - 65,000; Full time

Benefits offered by this job

Remote work

Job summary

Himalayas in TX seeks a licensed RN for a 6-month, full-time remote contract. The role focuses on initial and concurrent reviews, discharge coordination, and liaison activities to determine medical necessity and appropriate treatment plans.

Requirements include an active RN license, 3 years of clinical experience in a healthcare setting, and strong communication skills. Preferred: utilization management experience with MCG or InterQual.

Qualifications

• RN license required in state of operations.
• 3 years of clinical experience in physician office, hospital, or health insurance company.
• Verbal and written communication skills.

Responsibilities

• Perform initial and concurrent review activities.
• Discharge care coordination for efficiency and quality of medical/surgical services.
• Serve as liaison between providers and medical/network management divisions.
• Collect clinical and non-clinical data; verify eligibility and determine benefits.
• Provide information on utilization management requirements and procedures to members, providers, and facilities.

Skills

RN license

Clinical experience

Utilization management

Education

RN license

Job description

Himalayas in TX seeks a licensed RN for a 6-month, full-time remote contract. The role focuses on initial and concurrent reviews, discharge coordination, and liaison activities to determine medical necessity and appropriate treatment plans.

Requirements include an active RN license, 3 years of clinical experience in a healthcare setting, and strong communication skills. Preferred: utilization management experience with MCG or InterQual.