Utilization Management RN (79937)
$90,000–$90,000 year
Remote · Springfield, Illinois, United States
Job Summary
Utilization Management RN needed for full-time, remote-capable role supporting statewide utilization review for Illinois. Responsibilities include reviewing inpatient admissions and outpatient referrals to ensure appropriate levels of care and evaluate medical necessity and quality of care. Requires active Illinois RN license, proficiency in Word/Excel, and CPR/BLS certification. Preferred experience in utilization review, InterQual, and corrections. Position offers comprehensive benefits including health/dental/vision, 401(k), PTO, holidays, FSA, and continuing education. Shift is Monday through Friday, 8am-5pm; role is fully remote with location in Springfield, IL, and requires ability to obtain security clearance.
Required Qualifications
- Licensed RN in Illinois
- Active RN license (Illinois)
- Experience in utilization review (inpatient/outpatient or managed care)
- Proficiency with Microsoft Word and Excel
- Minimum one year RN experience in community outpatient clinic, hospital, or long-term care facility (preferred)
- Experience with InterQual (preferred)
- Corrections experience (preferred)
- CPR/BLS certification
- Ability to obtain security clearance (drug screen and background check)
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