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Remote Utilization Review RN III — Shape Care Decisions
Remote / Online - Candidates ideally in
Minnetonka, Hennepin County, Minnesota, 55345, USA
Listed on 2026-09-03
Minnetonka, Hennepin County, Minnesota, 55345, USA
Listing for:
Medica
Remote/Work from Home
position Listed on 2026-09-03
Job specializations:
-
Nursing
RN Nurse
Job Description & How to Apply Below
Medica, a nonprofit health plan serving multiple states, seeks an Utilization Review RN to review and document member case history and determine clinical benefits in line with policies. The role requires attention to detail and clinical judgment.
Responsibilities include prior authorization review, trend analysis, and collaboration with members, providers, and internal teams. Requirements: RN license, Associate or Bachelor's degree, and 5+ years of experience; remote work within Medica states.
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