Utilization RN: Non-Emergency Transport & Care

Verida Inc; Washington (District of Columbia); On-site; USD 85,000 - 105,000; Full time

Job summary

Southeastrans is hiring an on-site Registered Nurse in Washington, DC to oversee prior authorization and level-of-care determinations for non-emergency transportation. The RN will assess medical necessity and determine the most suitable transport mode, serving as a key clinical decision-maker for a nurse triage line.

Responsibilities include coordinating transportation requests, validating eligibility, and collaborating with disability services to ensure compliant, safe, and effective care

Qualifications

• Registered Nurse with multi-state license including DC, MD, VA.
• Knowledge of Medicaid guidelines.
• Strong clinical judgment and chart review skills.
• Comfort with utilization of review software and documentation systems.
• Excellent written and verbal communication skills.
• Strong analytical skills and time management.
• Self-motivated, able to work independently and under pressure.
• Experience with healthcare systems and Medicaid for low-income populations.
• Verifiable experience in medical utilization review.

Responsibilities

• Receive and manage transportation service requests via a centralized notification system.
• Verify beneficiary eligibility and collect required information.
• Determine appropriate transportation mode based on clinical need.
• Notify beneficiaries of transportation arrangements and estimates.
• Coordinate scheduling and providers; ensure authorization.

Skills

Multistate RN license

Clinical judgment

Chart review

Communication skills

Time management

Utilization review experience

Education

ADN/BSN

Tools

Utilization review software

Job description

Southeastrans is hiring an on-site Registered Nurse in Washington, DC to oversee prior authorization and level-of-care determinations for non-emergency transportation. The RN will assess medical necessity and determine the most suitable transport mode, serving as a key clinical decision-maker for a nurse triage line.

Responsibilities include coordinating transportation requests, validating eligibility, and collaborating with disability services to ensure compliant, safe, and effective care