RN Utilization Review - Remote

Overview

The RN Utilization Review position at MediGold Health Plan involves coordinating medical care for plan members and collaborating with healthcare providers, ensuring effective utilization management and quality care.

In Short

• Full-time remote RN position.
• Coordinate medical care for plan members.
• Participate in utilization management program development.
• Collaborate with various healthcare professionals.
• Document quality concerns and case management issues.
• Minimum of 5-7 years of clinical nursing experience required.
• 2 years of experience in utilization review or case management preferred.
• Competitive compensation and benefits package.
• Opportunities for professional development and tuition reimbursement.
• Join a diverse and inclusive workplace.

Requirements

• Associate or Bachelor's Degree in Nursing.
• Current RN license in home state or compact license.
• 5-7 years clinical nursing experience.
• Experience in utilization review or case management preferred.
• Ability to analyze and report medical utilization.
• Strong communication and documentation skills.

Benefits

• Medical, dental, and vision coverage starting on day one.
• Retirement savings account with employer match.
• Generous paid time off programs.
• Employee recognition programs.
• Tuition/professional development reimbursement.
• Relocation assistance available.
• DailyPay option for eligible employees.
• Diversity, Equity, and Inclusion initiatives.