Remote Utilization Review RN (InterQual) – PA Licensed

The Judge Group; Pennsylvania; Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three years of Medical/Surgical experience and proficiency with InterQual criteria. This position offers a day shift workload with flexible weekends and requires an active PA RN license.

Qualifications

• Minimum of three years of Medical/Surgical experience.
• Proficiency with InterQual criteria.
• Proficiency in Microsoft applications.

Responsibilities

• Review medical records and apply InterQual and medical policy criteria.
• Communicate with providers to clarify treatment plans.
• Identify discharge planning needs early.

Skills

Medical/Surgical experience

InterQual proficiency

Microsoft Word

Microsoft Outlook

Microsoft Excel

SharePoint

Adobe tools

Education

Active PA RN license

Job description

A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three years of Medical/Surgical experience and proficiency with InterQual criteria. This position offers a day shift workload with flexible weekends and requires an active PA RN license.