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Utilization Review Nurse
Utilization Review Nurse-March 2024
Baltimore
Mar 28, 2026
About Utilization Review Nurse

  Actalent is hiring an experienced RN Case Manager for a Remote Position.

  Description:

  Responsible for the day to day management of health confined plan members in acute care and/or rehabilitative facilities. The Utilization Nurse (UN) actively monitors the appropriateness of care received by plan members in a variety of settings, acute hospital, sub-acute hospital, and acute rehabilitation facility. The Utilization Nurse applies member benefit and medical criteria to determine authorization of services in coordination with the Medical Directors. The Utilization Nurse proactively initiates discharge planning for of members, including identification of post-discharge needs and coordination of post discharge referrals/services. The UN communicates verbally and in writing authorization and/or denial of covered services with providers, facilities and members. The UN is a member of administrative and clinical teams in the area of assignment. Clinical knowledge is maintained and updated and UN must maintain acceptable documentation and quality standards.

  Qualifications:

  Minimum of 5 years of Acute Care Nursing experience.

  Utilization review experience of at least two years.

  Graduate from an Accredited Nursing Program (Bachelors)

  Active MD or Compact RN License

  Diversity, Equity & Inclusion

  At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

  Hiring diverse talent

  Maintaining an inclusive environment through persistent self-reflection

  Building a culture of care, engagement, and recognition with clear outcomes

  Ensuring growth opportunities for our people

  Actalent is an equal opportunity employer.

  About Actalent

  Actalent connects passion with purpose. We help visionary companies advance their engineering and science initiatives through access to specialized experts that drive scale, innovation, and speed to market. With a network of almost 30,000 engineering and sciences consultants and more than 4,500 clients across the U.S., Canada, Asia, and Europe, Actalent serves many of the Fortune 500. An operating company of Allegis Group, the global leader in talent solutions, Actalent launched as a new specialized engineering and sciences services and workforce solutions brand in 2021.

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