Skip to content
RemoteRN
Post a job
3h ago Curated

Clinical Guide Part A: Utilization Management Nurse

Devoted Health

Job description

The Utilization Management Nurse applies clinical judgment to determine medical necessity for prior authorization requests using MCG criteria. This is a 100% remote role open to nurses with an active compact RN license. Requires 3+ years acute-care experience. BSN preferred. Salary range: $80,000–$100,000 plus bonus.

Key responsibilities

  • Apply MCG criteria to prior-auth requests
  • Render coverage determinations within SLA
  • Escalate complex cases to medical director

What you bring

  • Active compact RN license
  • 3+ years acute-care experience
  • Working knowledge of MCG or InterQual

Tags

100% RemoteCompact RNMCG

Related roles

More open utilization review positions — or browse every utilization review role.