Remote Utilization Review Nurse – Flexible 4 or 5 Day Schedule, Saturday Required

Join Martin's Point Health Care as a Utilization Review Nurse to ensure high-quality, cost-efficient medical outcomes for enrollees with inpatient/outpatient authorization needs. This role requires experience in utilization management and clinical nursing, with a focus on medical necessity reviews, claims disputes, and coordination of services.

Requirements

• 3+ years of clinical nursing experience as an RN, preferably in a hospital setting
• Utilization management experience in a health plan UM department
• Compact RN License
• Certification in managed care nursing or care management desired (CMCN or CCM)

Benefits

• Paid Time Off
• 401k Matching
• Retirement Plan