| Location | Houston, TX (Remote) |
| Salary | $48–$55 Per Hour |
Job Title: Registered Nurse – Utilization Review (Remote)
Location: Fort Myers, FL (Remote)
Job Type: Contract
Duration: 13 Weeks
Shift & Schedule: Day Shift | 8:00 AM – 4:30 PM | Monday – Friday | 40 Hours/Week | Every 5th Weekend Rotation | Remote
Local Candidates Required: Yes
Traveler Candidates Required: Yes
Pay Rate: $48 - $55/hr
Note: This job doesn't offer any benefits.
Position Overview
We are seeking an experienced RN to perform utilization review, assess medical necessity and level of care, and coordinate with providers and healthcare teams in a remote setting.
Required Qualifications
Active Registered Nurse (RN) license.
Minimum 2 years of Utilization Management/Utilization Review experience.
CCM or CMCN certification required.
Epic experience required.
DragonFly Utilization Management tool experience required.
Must be available for the every-fifth-weekend rotation.
Responsibilities
Perform utilization management and utilization review activities for assigned patients.
Review clinical information and medical records to support appropriate utilization of healthcare services.
Collaborate with providers and healthcare teams regarding medical necessity and level of care.
Utilize Epic and DragonFly for clinical review, documentation, and utilization management workflows.
Ensure accurate and timely documentation of utilization review activities.
Communicate effectively with providers, clinical staff, and other healthcare professionals.
Follow organizational policies, regulatory requirements, and utilization management guidelines.
Participate in the required every-fifth-weekend rotation.
Float to other sister campuses when need