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Utilization Management Nurse (RN) – Acute / Post-Acute
A Utilization Management Nurse (RN) – Acute / Post-Acute position is available courtesy of Adecco Healthcare and Life Sciences. We are seeking an experienced Utilization Management (UM) Nurse (RN) with a strong background in acute and post-acute care. This role supports inpatient authorization processes and ensures timely review and determination of medical necessity, directly contributing to organizational performance metrics and turnaround times. This role is critical to maintaining efficient inpatient authorization workflows and ensuring business goals are met through timely and accurate utilization reviews. Location: Remote (U.S.) Employment Type: Minimum 3-month temp/contract (possible extension) Work hours: Monday-Friday 8:00am-5:00pm CST Hourly pay range: $35.00-$39.00/hr. (based on experience) Key Responsibilities
- Perform inpatient utilization reviews for acute and post-acute cases
- Complete a minimum of 9 authorization determinations per day
- Evaluate clinical information to determine medical necessity and appropriate level of care
- Ensure compliance with established guidelines, policies, and regulatory standards
- Collaborate with interdisciplinary teams to support care coordination and decision-making
- Maintain accurate and timely documentation within internal systems
- Meet productivity and quality benchmarks related to authorization turnaround times
- Work independently while managing a consistent daily workload
- Collaborative team of approximately 10 RN reviewers
- Focused on inpatient acute utilization management
- Fast-paced, metrics-driven environment with strong emphasis on accountability and quality
- Active Registered Nurse (RN) license
- Minimum 2+ years of acute Utilization Management (UM) experience
- Strong clinical knowledge of inpatient acute and post-acute care
- Ability to work independently and maintain productivity standards
- Excellent critical thinking, decision-making, and organizational skills
- Proficiency in clinical documentation and electronic systems
- Experience with high-volume inpatient authorization reviews
- Strong time management and ability to prioritize tasks effectively
- Familiarity with payer guidelines and medical necessity criteria
- Weekly Pay
- 401(k) Plan
- Skills Training
- Excellent medical, dental, and vision benefits
- The California Fair Chance Act
- Los Angeles City Fair Chance Ordinance
- Los Angeles County Fair Chance Ordinance for Employers
- San Francisco Fair Chance Ordinance
Ref: US_EN_99_020730_2542222