Utilization Review RN

Job Summary

A healthcare organization is seeking a Utilization Review RN for a remote full-time position.

Key Responsibilities:

• Conduct assessments of medical services to validate appropriateness using established criteria and guidelines
• Examine and evaluate patient records to verify quality of care and necessity of services
• Input and manage essential clinical details within medical management platforms

Required Qualifications:

• Active and unrestricted RN license
• Minimum 2 years of clinical nursing experience
• At least 1 year of previous Utilization Management experience
• Background in medical or clinical practice through education or training
• Holds an unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a nursing degree from an accredited college (for RNs)