RN - Utilization Review (Remote) - Fort Myers, FL - JM 26-12698

Job Title: Registered Nurse – Utilization Review (Remote)
Location: Fort Myers, FL (Remote)
Job Type: Contract
Duration: 13 Weeks
Shift & Schedule: Day Shift | 8:00 AM – 4:30 PM | Monday – Friday | 40 Hours/Week | Every 5th Weekend Rotation | Remote
Local Candidates Required: Yes
Traveler Candidates Required: Yes

Pay Rate: $48 - $55/hr

Position Overview

We are seeking an experienced RN to perform utilization review, assess medical necessity and level of care, and coordinate with providers and healthcare teams in a remote setting.

Required Qualifications

• Active Registered Nurse (RN) license.

• Minimum 2 years of Utilization Management/Utilization Review experience.

• CCM or CMCN certification required.

• Epic experience required.

• DragonFly Utilization Management tool experience required.

• Must be available for the every-fifth-weekend rotation.

Responsibilities

• Perform utilization management and utilization review activities for assigned patients.

• Review clinical information and medical records to support appropriate utilization of healthcare services.

• Collaborate with providers and healthcare teams regarding medical necessity and level of care.

• Utilize Epic and DragonFly for clinical review, documentation, and utilization management workflows.

• Ensure accurate and timely documentation of utilization review activities.

• Communicate effectively with providers, clinical staff, and other healthcare professionals.

• Follow organizational policies, regulatory requirements, and utilization management guidelines.

• Participate in the required every-fifth-weekend rotation.

• Float to other sister campuses when need