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Utilization Management - Registered Nurse (Remote)
Utilization Management - Registered Nurse (Remote)
Join a team committed to clinical excellence, integrity, and patient-centered authorizations. BroadPath is seeking a Utilization Management RN to review authorization requests, apply clinical guidelines, and ensure that members receive high-quality, timely care.
What You’ll Do
- Review and process authorization requests using clinical guidelines and medical necessity criteria
- Coordinate with providers and internal teams to obtain required documentation and ensure accurate adjudication
- Analyze medical records, diagnoses, and treatment plans to support consistent, evidence-based decisions
- Monitor trends and identify opportunities for process improvements and cost efficiencies without sacrificing quality
What We’re Looking For
- Current Registered Nurse (RN) licensure in the U.S.
- Strong understanding of utilization management, medical necessity, and clinical criteria
- Excellent clinical documentation review skills and the ability to make sound decisions based on medical records
- Ability to work independently in a remote setting, while collaborating across teams
Why BroadPath?
- Fully remote work opportunity
- Culture of professional growth, clinical excellence, and accountability
- Meaningful impact on patient care and outcomes
BroadPath is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive work environment and encouraging applications from all qualified candidates, including women, minorities, and individuals with disabilities.
We are an Equal Employment Opportunity employer and welcome applications from diverse candidates.
