Job Description
Utilization Review Nurse – Contract Opportunity
Location: 100% Remote (working EST hours)
Schedule: Friday-Monday either 9am-7:30pm or 8am-6:30pm
Contract Length: 6 months with potential for extension or hire
Pay Rate: $39/hour (W2)
Start Date: ASAP
Equipment: Provided
Position Overview
We are seeking a Utilization Review Registered Nurse with strong recent bedside clinical experience and 2–3+ years of hospital-based Utilization Review. The ideal candidate is someone who has been actively patient-facing within the past 3–5 years (medsurg, ICU, trauma, or similar) and has transitioned into UR. Extensive UR experience without recent clinical exposure is not preferred.
In this role, you will perform first-level admission and continued stay case reviews, determine appropriate level of care using clinical documentation, and apply evidence-based criteria (InterQual required; MCG preferred).
- Required Qualifications
- Active RN license in state of residence
- Minimum 3 years of direct bedside clinical nursing experience (medsurg, ICU, trauma; no psych/GYN-only)
- At least 2–3 years of recent hospital-based Utilization Review experience
- InterQual experience required; MCG preferred
- Epic EMR exposure (must complete Epic compliance training)
- Strong analytical, documentation, and decision-making skills
- Knowledge of Medicare rules and UR regulatory standards
Training & Productivity Expectations
- Training:
- 2 weeks, Monday–Friday, 8:30 AM–4:30 PM CST
- Practice cases before transitioning to live reviews
- Productivity:
- Expected completion of 3 case reviews per hour
- Two 15-minute breaks and a 30-minute lunch are deducted from productivity tracking
- Responsibilities
- Conduct initial and continued stay reviews using InterQual and MCG criteria
- Confirm appropriate documentation and orders are present
- Abstract clinical data across multiple medical record formats
- Maintain quality, timeliness, and productivity standards
- Communicate effectively with internal stakeholders
- Support departmental goals and complete required HIPAA and compliance training
Job Types: Full-time, Contract
Pay: From $39.00 per hour
Expected hours: 40 per week
- Benefits:
- Dental insurance
- Health insurance
- Vision insurance
- Application Question(s):
- When is the most recent time you were working in a bedside clinical setting as an RN ?
- What hospital units have you worked in? (trauma, medsurg, etc...)
- Do you currently hold a California RN or Compact RN license?
- How many years of Utilization Review/Utilization Management experience do you have?
- How many years experience do you have working w MCG criteria?
- How many years of InterQual experience do you have?
- How many years of EPIC experience do you have?
- What is your ideal pay rate/hr?
- Are you comforable working either schedule:
Friday-Monday 9am-7:30pm or 8am-6:30pm
Work Location: Remote
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