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Registered Nurse - Utilization Management (Remote)

Mitchell Martin
  • Philadelphia, PA
  • Remote
  • $41.15–$46.15 Per Hour
  • Instant Apply
1 day ago
Mitchell Martin

Job Description

Registered Nurse - Utilization Management (Remote) - Philadelphia, PA (Remote) - Contract - Mon-Fri, Day Shift Hours - $41.15-$46.15 Per HR

Title:
Registered Nurse - Utilization Management (Remote)

Location:  Philadelphia, PA (Remote)
Employment Type: Contract - Mon-Fri, Day Shift Hours

Compensation:
Pay Range: $41.15-$46.15 Per HR

Description:
• This position involves working as a Registered Nurse specializing in Utilization Management. 
• The role is remote, with a requirement to reside in PA, NJ, or DE. 
• It is a contract position with day shift hours from Monday to Friday. 
• The role requires strong clinical judgment and experience in utilization management, along with proficiency in generic technology tools.

Requirements:
• Active, unrestricted RN license in PA or Compact states.
• Minimum of five years of clinical nursing or equivalent healthcare experience.
• Experience in utilization management or related managed care operations.
• Knowledge of clinical appeal processing and regulatory requirements.
• Strong written and verbal communication skills.
• Ability to manage competing priorities and meet deadlines.
• Proficiency with generic technology tools and systems.

Qualifications:
• BSN Preferred.
• Experience in health plan operations, including various plan types.
• Familiarity with utilization review criteria and guidelines.
• Experience with external review and complex medical necessity appeals.
• Knowledge of Medicare, Medicaid, and state-specific appeal requirements.
• Experience working with cross-functional healthcare teams.

Contact Authorization:
By applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. Message and data rates may apply for texts. Carriers are not liable for delayed or undelivered messages. You can access our privacy policy here https://www.mitchellmartin.com/privacy-policy 

Benefits:
Learn more about our benefits offerings here https://www.mitchellmartin.com/careers/benefits-perks 

Onboarding Expectations:
Learn more about our Onboarding Process here https://youtu.be/rjV_NFYjyY4 

EEO Statement:
Learn more about our EEO policy here https://www.mitchellmartin.com/eoe-statement 

Please email: christina.impellizeri@hcmmi.com

Numbers & Facts

LocationPhiladelphia, PA (
Remote
)
IndustryStaffing/Employment Agencies
Salary$41.15–$46.15 Per Hour
Company Size100 to 499 employees
Year Founded1984
Websitehttps://www.mitchellmartin.com

About Company

OUR FOCUS IS GROWTH

It’s not just about filling job openings.  It’s about enabling growth and inspiring success.  That’s what we do.

Mitchell Martin is one of the nation’s largest staffing companies, with offices throughout the US as well as in India and the Philippines.  We help drive success for both people and companies by helping them achieve positive growth.   We do this by building strong relationships and developing a deep understanding of the people we work with, in order to facilitate the best matches for both sides of the equation.    

Skills

  • Clinical Nursingunmatched
  • Communication Skillsunmatched
  • Cross-Functionalunmatched
  • Health Planunmatched
  • Healthcareunmatched
  • Managed Careunmatched
  • Medicaidunmatched
  • Medicareunmatched
  • Onboardingunmatched
  • Operations Managementunmatched
  • Operations Planningunmatched
  • Presentation/Verbal Skillsunmatched
  • Registered Nurse (RN)unmatched
  • Regulatory Requirementsunmatched
  • Time Managementunmatched
  • Utilization Managementunmatched
  • Writing Skillsunmatched

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