We're Hiring: Utilization Management Nurse
REMOTE
• Job Type: Part-Time
• Department: Utilization Management
About Us:
At bServed UM, we’re transforming the way healthcare organizations manage utilization. Our mission is to improve patient outcomes while helping hospitals and providers reduce costs. We specialize in lowering denial rates, optimizing length of stay, and supporting Case Management teams across hospitals, IPAs, and insurance companies.
The Role:
We are seeking a dedicated Utilization Management Nurse to join our growing team. You’ll play a key role in reviewing the medical necessity and appropriateness of care using clinical guidelines and collaborating with providers and payers to ensure efficient, effective patient care.
Key Responsibilities:
✅ Conduct prospective, concurrent, and retrospective reviews
✅ Apply InterQual criteria to support UM decisions
✅ Collaborate with providers and payers on authorizations and discharges
✅ Document and justify clinical decisions in compliance with regulations
✅ Support appeals, monitor high-cost cases, and promote cost-effective care
What We’re Looking For:
✔ Active LVN/RN license (State-specific or Compact)
✔ 2+ years clinical nursing experience (med-surg, acute, etc.)
✔ 2+ years in Utilization Review or Case Management experience required
✔ InterQual experience required
✔ Excellent communication, organization, and critical thinking
Bonus Points:
➕ BSN preferred
➕ CCM or UR certification
➕ Experience with Medicare, Medicaid, or commercial payers
Why Join Us?
✨ Make a real impact in healthcare
✨ Be part of an innovative, growing team
✨ Flexible work environment
✨ Competitive compensation
Job Type: Full-time
Pay: $30.00 - $40.00 per hour
Benefits:
• Paid time off
Work Location: Remote
Apply Now
Apply Now