Remote Utilization Review RN - Flexible, High-Paying

MaziCTools; United States; Hybrid; USD 90,000 - 115,000; Part time

Benefits offered by this job

Flexible work hours

Health insurance

401(k) plans

Paid time off

Continuing education

Job summary

MaziCTools is seeking a dedicated RN with utilization review experience for a remote nursing role. The position emphasizes evaluating the necessity of treatments, coordinating with healthcare teams, and ensuring adherence to payor policies from a home-based setting across the United States.

Ideal candidates have at least 3 years of clinical nursing and strong analytical skills, with proficiency in EHR systems and excellent communication.

Qualifications

• Active RN license in your state.
• Minimum 3 years nursing experience, hospital, outpatient or specialty setting preferred.
• Experience in utilization review or related fields is preferred but not mandatory.
• Strong analytical and problem-solving abilities.
• Excellent communication and interpersonal skills; collaborate with diverse stakeholders.
• Proficient in electronic health records and healthcare management software.

Responsibilities

• Conduct comprehensive reviews of patient records to determine necessity of services.
• Collaborate with providers to ensure compliance with guidelines and payor policies.
• Communicate effectively to facilitate care coordination.
• Document findings and recommendations to support decisions.
• Stay current with regulations and guidelines; participate in trainings.

Skills

RN license

3+ years clinical nursing

Utilization review

Case management

Analytical thinking

EHR proficiency

Communication skills

Job description

MaziCTools is seeking a dedicated RN with utilization review experience for a remote nursing role. The position emphasizes evaluating the necessity of treatments, coordinating with healthcare teams, and ensuring adherence to payor policies from a home-based setting across the United States.

Ideal candidates have at least 3 years of clinical nursing and strong analytical skills, with proficiency in EHR systems and excellent communication.