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Remote Utilization Management Nurse

May 8, 2026

A company is looking for a Utilization Management Nurse Consultant specializing in Medical Review (Remote).

Key Responsibilities

Implement, coordinate, monitor, and evaluate medical review cases using clinical expertise
Apply clinical criteria and guidelines to make medical determinations for clients
Assist in training new nurse reviewers and recommend process improvements to enhance quality and client satisfaction

Required Qualifications

Active, unrestricted RN license with multistate/compact licensure privileges
Minimum 3 years of clinical experience
5 years of experience making independent clinical decisions
1+ year of Utilization Review Management and/or Medical Management experience
Commitment to a mandatory 2-week training program

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