RN Utilization Review Clinician

Location: Remote

Compensation: To Be Discussed

Reviewed: Wed, Apr 01, 2026

This job expires in: 6 days

Job Category: Case Management

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Some College, Bachelors

Job Summary

A company is looking for a Utilization Review Clinician - Appeals.

Key Responsibilities:

Review appeals related to denied authorizations, level of care determinations, or coverage issues
Classify appeals accurately and ensure compliance with regulatory and organizational requirements
Participate in team meetings and maintain review consistency through educational activities

Required Qualifications:

Bachelor's degree or equivalent work experience
4-6 years of clinical nursing or therapy experience
Active RN, OT, or PT license

COMPLETE JOB DESCRIPTION

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