Virginia Licensed Utilization Management RN

Job Summary

To support patient care quality and compliance, the part-time Virginia Licensed Utilization Management RN will independently assess medical necessity, collaborate with interdisciplinary teams, and ensure adherence to regulatory and payer standards in a remote setting.

Key responsibilities

• Review patient admissions to determine medical necessity and appropriate level of care
• Communicate with healthcare teams to clarify or adjust patient status as needed
• Engage with insurance payers to support authorization and reimbursement processes

Required qualifications

• Bachelor of Science in Nursing from an accredited nursing program
• Two years of acute care hospital experience
• Licensed to practice as a Registered Nurse in the Commonwealth of Virginia