Join our Utilization Management team as a Nurse Consultant, where you'll apply clinical judgment and evidence-based criteria to review inpatient and outpatient services. You'll collaborate with providers, authorize care, and escalate cases when needed, all while navigating multiple systems and maintaining accurate documentation. This role suits nurses who thrive in fast-paced environments, are highly organized, and comfortable with computer-based work. Key Responsibilities. Participate in occasional on-call rotations, including some weekends and holidays, per URAC and client requirements. Perform sedentary work that primarily involves extended periods of sitting, as well as frequent talking, listening, and use of a computer. Thrive in a fast-paced, high-volume environment with strong organizational, multitasking, and prioritization skills. Apply critical thinking and evidence-based clinical criteria to evaluate outpatient and inpatient services requiring precertification and concurrent review. Conduct clinical reviews via phone and electronic documentation, collaborating with healthcare providers to gather necessary information. Use established guidelines to authorize services or escalate to Medical Directors as needed. Navigate multiple computer systems efficiently while maintaining accurate documentation. Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring continuity of care and operational support. Remote Work Expectations. This is a 100% remote role; candidates must have a dedicated workspace free of interruptions. Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted. Required Qualifications. Active unrestricted state Registered Nurse licensure in state of residence required . year of prior authorization of injectable/infused specialty medication experience. Minimum 5 years of relevant experience in Nursing. At least 1 year of Utilization Management experience in concurrent review or prior authorization. Strong decision-making skills and clinical judgment in independent scenarios. Proficient with phone systems, clinical documentation tools, and navigating multiple digital platforms. Commitment to attend a mandatory 3-week training (Monday–Friday, 8:30 am–5:00 pm EST) with 100% participation. Preferred Qualifications. Experience with NCCN criteria preferred . year of experience in a managed care organization (MCO). Experience in a high-volume clinical call center or prior remote work environment. Education. Associate's degree in nursing (RN) required, BSN preferred. Anticipated Weekly Hours 40 Time Type. Full time. Pay Range. The typical pay range for this role is:$29.10 - $62.32