Utilization Review Registered Nurse
Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding experienced RNs to its clinical team. This is a hands-on remote nursing role. You’ll work through clinical cases, review the information available, identify what is missing, determine the appropriate next step, and escalate when needed.
The work can touch prior authorization, utilization review, care coordination, patient access, and other clinical workflows, but this is not a traditional UM-only position. What you’ll do Review patient records, clinical notes, orders, medications, labs, imaging, and other supporting documentation Identify missing or conflicting information and follow up when additional documentation is needed Use clinical judgment and established guidelines to determine next steps Escalate cases that need additional clinical review Support authorization, utilization, care coordination, and patient-access workflows Document findings and decisions clearly Manage a steady volume of cases in a remote environment Work with clinical and operations teams to resolve issues and improve workflows Help with process, documentation, or training improvements as you become familiar with the work What we’re looking for Active RN license BSN preferred 3 years of RN experience Strong clinical judgment Strong documentation skills Comfortable working independently Able to manage multiple cases and priorities at once Comfortable learning new systems and workflows Able to recognize when something does not look right and needs to be escalated Experience in telehealth, virtual care, telephone triage, care management, clinical review, utilization review, prior authorization, population health, chart review, or digital health is especially relevant. We’re also interested in nurses who have taken on responsibilities like precepting, charge coverage, auditing, training, or serving as a go-to resource for other nurses.
Position details Pay: $48–$65/hour, based on experience Schedule: Monday–Friday, 9:00 AM–6:00 PM ET Location: Fully remote within the U.S.
Employment: Long-term W-2 contract through Medix Payroll: Weekly Benefits: Eligibility after 30 days Equipment: Company-issued equipment provided Start timing: Typically around two weeks from offer, with some flexibility
