Remote Utilization Review RN (PRN)

Dane Street, LLC; United States; On-site; USD 65,000 - 90,000; Part time

Benefits offered by this job

Health Insurance

401k Plan

Performance Bonuses

Apple equipment for remote workspace

Media stipend

Job summary

Dane Street, LLC seeks a Utilization Management Nurse Reviewer for flexible PRN support. You will review medical records and treatment plans to determine necessity, collaborate with providers and payers, and ensure adherence to UR guidelines. A valid LVN/LPN or RN license is required.

Responsibilities include coordinating care, performing utilization reviews, and ensuring timely, evidence-based decisions. This role supports our team during peak times and holidays, with a comprehensive benefits

Qualifications

• 2 yrs minimum clinical nursing experience.
• One year of Utilization Management experience required.
• Strong written and verbal communication skills.

Responsibilities

• Conduct medical necessity reviews using established guidelines.
• Examine patient records to verify care quality and necessity.
• Provide clinical guidance to non-clinical staff and coordinate with care teams.
• Enter and manage clinical data in management systems.
• Stay current with UR regulatory requirements and standards.
• Advise management and physicians to optimize patient care pathways.

Skills

Communication

Interpersonal skills

Critical thinking

Organizational skills

Multitasking

Education

LVN/LPN license

Tools

MS Word

MS Excel

MS PowerPoint

Outlook

Job description

Dane Street, LLC seeks a Utilization Management Nurse Reviewer for flexible PRN support. You will review medical records and treatment plans to determine necessity, collaborate with providers and payers, and ensure adherence to UR guidelines. A valid LVN/LPN or RN license is required.

Responsibilities include coordinating care, performing utilization reviews, and ensuring timely, evidence-based decisions. This role supports our team during peak times and holidays, with a comprehensive benefits