Utilization Review Nurse, RN

About the Role

Personify Health seeks a Utilization Review Nurse to provide medical necessity assessments remotely with weekend availability.

Key Responsibilities

• Review outpatient and inpatient medical requests.
• Ensure compliance with guidelines and benefit determinations.
• Collaborate with hospital staff for discharge planning.
• Process appeals and documentation.

Requirements

• Current RN license in US or territory.
• Minimum 1 year clinical experience.
• Knowledge of medical claims and coding.

Benefits & Compensation

• $32 to $36 per hour.
• Health, dental, vision, mental health benefits.
• Flexible scheduling.

Work Schedule

• Weekend availability required.
• Call and night shift details not specified.