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Job details

Utilization Review Nurse

Job Summary

A company is looking for a Utilization Review Nurse, part-time, remote.

Key Responsibilities
  • Review and evaluate electronic medical records of emergency department admissions for medical necessity using InterQual or MCG criteria
  • Apply evidence-based clinical guidelines to assess and ensure proper utilization of healthcare resources
  • Participate in telephonic discussions with emergency department physicians regarding documentation and admission status
Required Qualifications
  • Current and unrestricted RN license
  • At least 3 years clinical experience in an acute care setting, specifically in emergency room, critical care, or medical/surgical nursing
  • At least 2 years of utilization management experience in acute admission and concurrent reviews
  • Intermediate level experience with InterQual and/or MCG criteria within the last two years
  • Proficiency in medical record review in an electronic medical record (EMR)

Average salary estimate

$70000 / YEARLY (est.)
min
max
$60000K
$80000K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

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FUNDING
SENIORITY LEVEL REQUIREMENT
TEAM SIZE
No info
EMPLOYMENT TYPE
Part-time, remote
DATE POSTED
May 22, 2025

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