Registered Nurse, Utilization Review

Job overview

The Registered Nurse, Utilization Review role is remote, with a Monday–Friday schedule from 8:00 a.m. to 4:30 p.m. and a rotation every fifth weekend. Compensation is not specified. The role supports utilization management and requires provider-side experience. The nurse applies clinical experience and utilization management tools to review cases and support appropriate care decisions. The position also requires Epic and Dragonfly experience, CCM or CMCN, and willingness to float to other sister campuses when required.

What you'll do

• Perform utilization management work
• use Epic and the Dragonfly UM tool
• bring experience working with providers, not only payers
• participate in the every-fifth-weekend rotation
• float as required, including potentially to sister campuses
• meet the stated degree accreditation verification or experience requirement.

What we're looking for

Skills & competencies

registered nurse

utilization review

remote

enterprise solutions-healthcare

utilization management

monday–friday

8:00 a.m.–4:30 p.m.

every fifth weekend

epic

dragonfly

ccm

cmcn

floating required

Work arrangement

• Weekend coverage required

Why this role

CCM or CMCN, Epic, and Dragonfly experience are required. Prior travel is highly preferred; the posting states a 50-mile radius rule and that the employer does not supply the computer.

About the employer

Enterprise Solutions-Healthcare is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.