Utilization Management Nurse Consultant

What You'll Do

Review clinical records to determine medical necessity and appropriate benefit utilization.

Coordinate and document utilization and benefit management activities.

Collaborate with providers and facilities to support safe, efficient discharge planning.

Ensure compliance with federal and state turnaround time requirements.

Communicate clearly and professionally with providers and internal partners.

Support department needs, including occasional weekend rotation and minimal travel for audits.

Schedule & Coverage

• Monday–Friday, 8‑hour shift between 8:00 AM–6:00 PM (local time zone)
• Weekend (Saturday) rotation as needed
• Candidates in PST or MST encouraged to apply to support extended daily coverage
• Up to 10% travel may be required for clinical audits

Required Qualifications

• Active, unrestricted RN license (CA license may be required)
• 3+ years of acute hospital RN experience (Med‑Surg and/or ICU preferred)

Preferred Qualifications

• 1+ year of Utilization Review and/or Managed Care experience
• Strong telephonic and professional communication skills
• Proficiency with Microsoft Office (Word, Excel, PowerPoint, Outlook)
• Ability to multitask across systems while using a computer station and sitting for extended periods
• Strong clinical judgment, organization, and time‑management skills

Education

• Associate Degree in Nursing (required)
• BSN (preferred)

Benefits

• 100% remote work from anywhere in the U.S.
• Meaningful role influencing quality, cost‑effective care
• Supportive, fast‑paced team environment

Full‑time position eligible for a comprehensive benefits package that includes medical, dental, vision coverage, paid time off, retirement savings options, wellness programs, and other resources based on eligibility.

Weekly Hours

40

Time Type

Full time

Pay Range

Hourly range: $29.10 – $62.32

This is the base pay; final offer depends on experience, education, geography and other factors. Eligibility for bonus, commission or short‑term incentive programs is also available.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.