Remote Utilization Review RN - Part-Time Evenings/Weekends

NRI, Inc.; Washington (District of Columbia); Remote; USD 30,000 - 50,000; Part time

Benefits offered by this job

100% remote

Part-time schedule

Evenings & Weekends

Job summary

NRI, Inc. is seeking an experienced Registered Nurse (RN) for Utilization Review to support long-term care patients and facilities from a remote role. This 100% remote position emphasizes efficient reviews, regulatory compliance, and collaboration with care teams across locations.

The role offers 10-20 hours per week with flexibility for evenings and weekends, making it ideal for RNs seeking supplemental or flexible work while staying clinically engaged.

Qualifications

• Experience with Utilization Review or Utilization Management.
• Long-term care experience.
• Admissions screening and care planning experience.
• Familiarity with MDS and Medicare/Medicaid criteria.
• Experience with continued stay reviews and quality improvement.

Responsibilities

• Conduct utilization management and quality reviews to evaluate medical necessity, patient acuity, and continued need for services.
• Review clinical documentation, care plans, and patient records for compliance with Medicare, Medicaid, PASRR, MDS, and other regulatory requirements.
• Evaluate appropriate levels of care and identify potential gaps or concerns.
• Collaborate virtually with providers, care teams, and other healthcare professionals.
• Support quality improvement, regulatory compliance, and appropriate utilization of services.
• Complete accurate and timely clinical reviews and documentation.
• Manage multiple cases while meeting established deadlines.

Skills

Utilization Review

Long-term care

Admissions screening

MDS

Medicare/Medicaid criteria

Continued stay reviews

Quality improvement

Clinical documentation review

Jiva

Tools

Jiva

Job description

NRI, Inc. is seeking an experienced Registered Nurse (RN) for Utilization Review to support long-term care patients and facilities from a remote role. This 100% remote position emphasizes efficient reviews, regulatory compliance, and collaboration with care teams across locations.

The role offers 10-20 hours per week with flexibility for evenings and weekends, making it ideal for RNs seeking supplemental or flexible work while staying clinically engaged.