Remote Utilization Review RN Flexible Shifts & Tuition Reimb

Ensemble Health Partners; Ohio; Hybrid; USD 63,000 - 95,000; Full time

Benefits offered by this job

Premium pay weekends

Shift differential

Comprehensive benefits

Job summary

Ensemble Health Partners is seeking a registered nurse to join our Utilization Review team in a remote capacity, with travel to client sites as needed. The role focuses on medical necessity determinations, care coordination, and denials management, with a salary range of $63,100-$94,650 based on experience and credentials.

Candidates must hold an active RN license (compact license preferred) and demonstrate strong collaboration across multidisciplinary teams.

Qualifications

• RN knowledge and clinical background required.
• Utilization review and case coordination experience preferred.
• Strong communication and teamwork abilities.
• Ability to prioritize and manage multiple cases.

Responsibilities

• Perform utilization reviews and determine medical necessity.
• Collaborate with physicians, FCC, payors, and care management staff.
• Document outcomes and monitor denial trends for performance improvement.
• Coordinate scheduling and patient care prioritization per department policies.

Job description

Ensemble Health Partners is seeking a registered nurse to join our Utilization Review team in a remote capacity, with travel to client sites as needed. The role focuses on medical necessity determinations, care coordination, and denials management, with a salary range of $63,100-$94,650 based on experience and credentials.

Candidates must hold an active RN license (compact license preferred) and demonstrate strong collaboration across multidisciplinary teams.