Remote RN Utilization Management
Company: VirtualVocations
Location: Santa Clara
Posted on: May 2, 2025
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Job Description:
A company is looking for a Telephonic Utilization Management &
Case Management Operations Registered Nurse, Remote.
Key Responsibilities
Review authorization requests using clinical judgment to ensure
medical necessity and appropriate level of care
Conduct comprehensive assessments and develop case management care
plans in collaboration with beneficiaries and healthcare
providers
Monitor and evaluate care plans to ensure effectiveness and achieve
desired outcomes
Required Qualifications
Current, unrestricted RN license with multi-state privileges or
ability to obtain them
3+ years of experience as a nurse in a clinical setting
2+ years of experience performing utilization review for a health
plan or inpatient facility
1+ year of experience as a case manager for a health plan or
inpatient facility
Strong technical proficiency with MS Office Suite and ability to
navigate multiple systems
Keywords: VirtualVocations, Merced , Remote RN Utilization Management, Healthcare , Santa Clara, California
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