Remote Utilization Management / Quality RN (3+ Openings)
100% Remote | Full-Time or Part-Time | $60–$63/hr | Start ASAP
We are seeking three or more experienced RN professionals with Utilization Management (UM) and/or Quality experience. These roles are fully remote with flexible scheduling and immediate interview/start availability.
Schedule Options
Full-Time: 37.5 hours/week
Part-Time: Evenings (5–8 PM) or Weekends
Role Summary
The UM/Quality RN is responsible for evaluating medical necessity, quality, and appropriateness of care, ensuring compliance with clinical guidelines and regulatory requirements. The role includes utilization review, care coordination support, and timely clinical determination notifications.
Key Responsibilities
Assess member needs to support high-quality, cost-effective care
Review and manage provider/member utilization requests
Render timely clinical determinations per policy and regulation
Issue approval/denial notifications within required timeframes
Coordinate with physicians, discharge planners, SMEs, and internal leaders
Support utilization tracking and quality monitoring processes
Work independently under general supervision
Required Qualifications
Active RN license
UM experience required
Quality experience preferred
Strong communication, clinical judgment, and documentation skills
Ability to work effectively in a remote environment
Compensation
$60–$63 per hour
How to Apply
Send resumes to: mfesinstine@phaxis.com
An Equal Employment Opportunity Employer
