Remote Utilization Review Nurse (RN) – Indiana Healthcare Review Specialist

Remote Utilization Review Nurse (RN) – Indiana Healthcare Review Specialist

Company: MedAxis Care Management

Location: Indiana, United States (Remote)

MedAxis Care Management is seeking an experienced Utilization Review Nurse to join our remote clinical review team. This position supports healthcare organizations by reviewing medical records, evaluating clinical necessity, and promoting high-quality, cost-effective patient care.

The Remote Utilization Review Nurse will collaborate with physicians, case managers, and healthcare partners to ensure patients receive appropriate care while maintaining compliance with healthcare guidelines and industry standards.

Responsibilities

• Review clinical records and healthcare documentation
• Evaluate medical necessity and level-of-care decisions
• Collaborate with providers regarding clinical information
• Identify opportunities for improved patient outcomes
• Complete utilization review assessments
• Maintain accurate documentation in review platforms
• Apply evidence-based healthcare guidelines
• Participate in quality improvement activities

Qualifications

• Active Registered Nurse (RN) license
• Clinical nursing experience required
• Knowledge of utilization management practices
• Strong analytical and documentation skills
• Experience reviewing medical records preferred
• Ability to work independently in a remote environment

Preferred Experience

• Hospital nursing
• Insurance review
• Case management
• Clinical documentation improvement

Technology Used

• Utilization management platforms
• Electronic medical records
• Clinical review software
• Secure healthcare communication tools

Schedule

Monday through Friday remote schedule with flexible daytime hours.

Benefits

• Medical Insurance
• Dental Insurance
• Vision Insurance
• 401(k) Retirement Plan
• Paid Time Off
• Annual Performance Bonus
• Certification Reimbursement
• Remote Work Allowance

Why Join MedAxis Care Management?

MedAxis Care Management helps healthcare organizations deliver better outcomes through clinical expertise and technology-driven solutions. Our remote nurses make healthcare decisions more efficient and patient-focused.

MedAxis Care Management is an Equal Opportunity Employer. Applicants from Indianapolis, Fort Wayne, Evansville, South Bend, and communities throughout Indiana are encouraged to apply.