RN Utilization Management Nurse

Job Summary

Bringing expertise in utilization management nursing, the full-time or part-time RN Utilization Management Nurse will create clinical cases, evaluate AI model responses, and help establish standards for clinical evaluation in a remote contract role lasting 12 weeks.

Key responsibilities

• Create clinical tasks and evaluation rubrics focused on utilization management and medical necessity
• Synthesize fragmented records and assess clinical reasoning and documentation quality
• Apply structured rubrics and refine cases through calibration cycles based on specialist feedback

Required qualifications

• At least 3 years of relevant professional experience in utilization management nursing
• An active RN license or recognized credential appropriate to the role
• A relevant healthcare degree or equivalent practical experience
• Strong skills in clinical reasoning, chart review, and documentation
• Ability to follow standardized rubrics and work through fast-paced review cycles