Job Title: Registered Nurse - Utilization Management
Job Description

We are seeking a dedicated Registered Nurse with a strong background in utilization management to join our team. This role involves reviewing both handwritten and computer-generated documents, ensuring that criteria meet medical necessity for inpatient stays, and managing authorization processes efficiently.

ResponsibilitiesReview handwritten and computer-generated documents while prioritizing tasks effectively.Send cases to a medical director for review if criteria do not meet medical necessity for an inpatient stay.Follow up with the Utilization Management department at hospitals by phone or fax to offer peer-to-peer reviews before sending official denials if an authorization is denied.Complete authorization reviews within a 1 business day turnaround time.Manage approximately 12-20 authorizations per day, including new and concurrent reviews.Essential SkillsActive TX RN LicenseExperience in Utilization Management and Concurrent ReviewStrong communication skillsStrong computer and documentation skillsExperience in Prior Authorization, Utilization Review, Discharge Planning, Interqual, Medical Management, and Managed CareAdditional Skills & QualificationsManaged care experience preferredWork Environment

This is a full remote work-from-home position. Working hours are Monday through Friday, from 8:00 am to 5:00 pm. The dress code is business casual.

Pay and Benefits

The pay range for this position is $35.00 - $39.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Feb 28, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

Hiring diverse talent Maintaining an inclusive environment through persistent self-reflection Building a culture of care, engagement, and recognition with clear outcomes Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.