Remote Utilization Review Registered Nurse

Overview

• Provide remote utilization review services for a healthcare organization, ensuring compliance with clinical guidelines and optimizing patient care outcomes.
• Work within a Level II Trauma Center environment, contributing to the effective management of patient care processes.
• Collaborate with healthcare teams to review patient cases and recommend appropriate care plans.
• Utilize EPIC charting systems to document and analyze patient information and care recommendations.
• Ensure adherence to regulatory and organizational standards in utilization review practices.
• Participate in a fully remote work arrangement, providing flexibility and work-life balance.
• Contribute to the healthcare organization's mission of delivering high-quality patient care.
• Maintain professional certifications and licenses, including BLS and WA RN License.

Key Responsibilities & Duties

• Conduct utilization reviews to assess patient care plans and ensure optimal resource use.
• Collaborate with multidisciplinary teams to provide recommendations for patient care improvements.
• Document patient care reviews and recommendations using EPIC charting systems.
• Ensure compliance with clinical guidelines and regulatory requirements in all reviews.
• Participate in remote meetings and discussions with healthcare teams and management.
• Maintain up-to-date knowledge of clinical practices and utilization review standards.
• Provide feedback to improve patient care processes and resource allocation.
• Adhere to organizational policies and procedures in all professional activities.

Job Requirements

• Associate of Science (AS) in Nursing or related field required.
• Active WA RN License and BLS certification mandatory.
• Minimum of 2 years of experience in utilization review or related nursing roles.
• Proficiency in EPIC charting systems for documentation and analysis.
• Strong understanding of clinical guidelines and healthcare regulations.
• Ability to work independently in a remote setting while meeting organizational goals.
• Excellent communication skills for collaboration with healthcare teams.
• Commitment to maintaining professional certifications and continuous learning.