Work from Home Utilization Review Registered Nurse

  • Location
    Raleigh, North Carolina
  • Job type
  • Category
    Medical & Science - Nursing

A Work from home Utilization Review Registered Nurse job in across the United States is now available through Adecco Medical and Science. One year of clinical experience with case management and as a Professional Registered Nurse in good standing is required to be considered. This long term project job offers full time day hours, an extremely lucrative rate, and a complete benefits package.

In this role, you will be responsible for collecting case specific member information, review and certify the medical necessity of prospective, concurrent, and retrospective units of inpatient and outpatient services.

Job Duties include:

Review each case and determine the most appropriate services, the most appropriate setting in which the services should be delivered, the most cost efficient methods for care of delivery, and the need for planning subsequent care for contracted members and their eligible dependents as assigned.
Providing clinical and managed care expertise, as well as Medical Director/physician consultation.
Provide first level clinical review for all inpatient and outpatient services requiring authorization for assigned client group regarding:
Prospective Review Urgent/ Non-urgent, Concurrent Review, Retrospective Review, Early initiation of discharge coordination,
Analyze case-specific patient information.
Verify eligibility, as applicable, and past utilization history.
They will be working from home 100% no travel required**

Mon-Fri regular business hours


Must be a Registered Nurse in good standing
Minimum 1 year of clinical experience working in case management
Wireless home connection required for data upload upon hiring

If you are interested in this Utilization Review Registered Nurse job in across the United States please send your resume directly to for immediate consideration.

Apply online for this and other great Nursing job opportunities:

Equal Opportunity Employer Minorities/Women/Veterans/Disabled

  • Apply with Adecco

Reference number US_EN_2_101084_324922