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Remote Utilization Review Nurse
Overview
IntePros is seeking an experienced Utilization Review Nurse to join our client\'s team. In this role, you’ll help ensure patients receive the right level of care by reviewing documentation, authorizations, and compliance with Medicare and CMS guidelines. You’ll work closely with providers, payers, and internal teams to coordinate care, optimize resources, and support positive patient outcomes.
Base pay range
$30.00/hr - $45.00/hr
What You’ll Do
- Review and process patient prior authorizations and reauthorizations.
- Determine the need for continued home health services in line with Medicare and Milliman Care Guidelines.
- Collaborate with providers, payers, and care teams to ensure efficient, cost-effective care.
- Maintain accurate records and prepare required reports.
- Provide feedback to clinicians on documentation, compliance, and care planning.
- Participate in weekend/holiday rotation as needed.
What We’re Looking For
- Licensed RN/LPN/LVN in good standing.
- 2+ years of general nursing experience (medical, surgical, or critical care).
- 1+ year of utilization review, case management, or home health experience.
- Strong knowledge of home health regulations and managed care processes.
- Excellent communication, organization, and time management skills.
- Proficiency with EMR systems and MS Office Suite.
Why Join Us?
You’ll be part of a team that values collaboration, compliance, and patient-centered care. We support ongoing education and professional growth while offering the flexibility of remote work.
