Remote Utilization Management Nurse (RN)

Job Overview

  • Clinical License RN
  • State(s) Nationwide


My name is Tony Mirza, working as a Sr. Talent Acquisition at Panzer Solutions, a global Staff Augmentation company specializing in development and staffing/recruitment, both Consulting and Full Time positions. If you are interested in the opportunity listed below, please respond with an updated copy of your resume including the best time to reach You or contact me on 860-661-7668.

Role: Utilization Management Nurse

Location: Remote

Duration: Contract

Candidates must have the following:

3+ years managed care experience as a Utilization Management Nurse

Active RN compact license

Interqual criteria experience

Personal lap top and monitors for work

*RN’s with Pennsylvania license preferred

About the job

The Utilization Management Nurse will use his/her professional judgment to evaluate the request and ensure that services are appropriately approved, recognize care coordination opportunities and refer those cases to Population Health as needed. The Utilization Management Nurse will apply independent medical judgment to medical health benefit policy and medical management guidelines to authorize services and appropriately identify and refer requests to the Medical Director when indicated. The Utilization Management Nurse will ensure that treatment delivered is appropriate and meets the Member’s needs in the least restrictive, least intrusive manner possible.

The Utilization Management Nurse will maintain current knowledge and understanding of and regularly apply the laws, regulations, and policies that pertain to the organizational business units and uses clinical judgment in their application.

This description provides a general overview ot the position, recognizing that day to day duties of each individual in the position may vary based on personal experience, skills, supervision, cases and other factors.

Job Type: Contract

Salary: $23.00 – $27.00 per hour

Expected hours: 40 per week

Medical specialties:

  • Home Health

Physical setting:

  • Nursing home

Work Location: Remote

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