Temporary UM RN (Fully Remote)

Healthedge; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Healthedge is seeking a Registered Nurse to review and authorize requests related to elective, direct, ancillary, urgent, and emergency services. You will collaborate with medical and support personnel to suggest alternative treatments and service levels, and coordinate discharge planning with the appropriate entities to ensure smooth transitions of care.

The ideal candidate brings 2+ years in acute care or discharge planning, strong communication skills, and familiarity with healthcare

Qualifications

• Registered Nurse with current unrestricted license is required.
• Minimum 2 years of clinical experience in acute care, discharge planning, case management, or utilization review.
• Excellent written and verbal communication and customer service skills.
• Working knowledge of Microsoft Office Suite.

Responsibilities

• Review and authorize requests for elective, direct, ancillary, urgent, and emergency services.
• Contact medical and support personnel to recommend alternative treatment and service levels.
• Establish and communicate discharge planning needs with appropriate entities.

Skills

Communication

Customer service

Microsoft Office

Clinical criteria

Accreditation standards

Education

RN license

Tools

Microsoft Office

Job description

• Review and authorize requests for elective, direct, ancillary, urgent, and emergency services.
• Contact medical and support personnel to recommend alternative treatment and service levels.
• Establish and communicate discharge planning needs with appropriate entities.

Qualifications:

• Registered Nurse with current unrestricted license required.
• Minimum 2 years' clinical experience in acute care, discharge planning, case management, or utilization review.
• Minimum 1 year health insurance or managed care environment preferred.
• Excellent written and verbal communication and customer service skills.
• Working knowledge of Microsoft Office Suite.
• Ability to apply clinical criteria and knowledge of accreditation standards.
• Long periods of sitting/standing in front of a computer using video technology.
• Occasional travel may be required.

Healthedge

HealthEdge provides AI-powered operational infrastructure for health insurance companies, helping them modernize operations and compete effectively. The company is expanding and investing in its people, offering opportunities to shape the future of healthcare technology.