Utilization Review Nurse - RN | Remote | Part-Time
Washington, District of Columbia, 20004, USA
Listed on 2026-10-02
-
Nursing
RN Nurse, Healthcare Nursing, Nurse Practitioner, Clinical Nurse Specialist
Utilization Review Nurse - RN | 100% Remote | Part-Time
10-20 Hours Per Week | Flexible Schedule | Evenings & Weekends
Looking for a way to use your nursing experience without returning to a full-time bedside schedule?
We're seeking an experienced Registered Nurse (RN) with Utilization Review/long-term care experience to join a healthcare team supporting patients and long-term care facilities in the Washington, DC and Maryland area.
This is a 100% remote, part-time position offering approximately 10-20 hours per week
, with flexibility to work evenings and weekends. It's an excellent opportunity for an experienced nurse looking for a flexible schedule, supplemental work, or a way to stay clinically engaged outside of a traditional full-time role.
- 100% work from home - no office or facility visits required.
- Part-time: 10-20 hours per week.
- Flexible scheduling with evening and weekend availability.
- Use your clinical knowledge and nursing experience in a less traditional role.
- Review cases and documentation while helping support appropriate patient care and level-of-care decisions.
- Great opportunity for experienced RNs seeking work-life flexibility or supplemental hours
.
- Conduct utilization management and quality reviews to evaluate medical necessity, patient acuity, and continued need for services.
- Review clinical documentation, care plans, and patient records for compliance with Medicare, Medicaid, PASRR, MDS, and other regulatory requirements.
- Evaluate appropriate levels of care and identify potential gaps or concerns.
- Collaborate virtually with providers, care teams, and other healthcare professionals.
- Support quality improvement, regulatory compliance, and appropriate utilization of services.
- Complete accurate and timely clinical reviews and documentation.
- Manage multiple cases while meeting established deadlines.
The ideal candidate has experience with:
- Utilization Review or Utilization Management
- Long-term care
- Admissions screening and care planning
- MDS
- Medicare and Medicaid criteria
- Continued stay reviews
- Quality improvement
- Clinical documentation review
Experience with
Jiva or a similar medical management platform is a plus.
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