Utilization Management Nurse - Post Acute | Remote - MN or WI
Job Description
Title: Utilization Management Nurse - Post Acute
Location: Remote | Candidates must reside within Minnesota or Wisconsin
Job Type: Contract (3 months)
Compensation: $40-45/hr W2
Industry: Health Insurance
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About the Role
Our client, a well-established healthcare payer headquartered in Minnesota, is seeking a Utilization Management Nurse - Post Acute to support utilization review activities across post-acute care settings. This role plays a critical part in ensuring medically appropriate, cost-effective care by applying clinical judgment, evidence-based criteria, and member coverage guidelines. Job Description
In this role, you will be responsible for reviewing and documenting prior authorization requests and concurrent stays for post-acute services, including skilled nursing facilities, acute inpatient rehabilitation, and long-term acute care hospitals. You will evaluate member case history and determine medical necessity in alignment with established policies, procedures, and clinical criteria (MCG).
The Utilization Management Nurse collaborates closely with members, providers, facilities, medical directors, intake staff, case managers, and internal departments to support timely and accurate utilization decisions. Strong attention to detail, sound clinical judgment, and comfort working across multiple systems are essential for success. Qualifications
Required
• Associate or Bachelor's degree in Nursing
• Active, unrestricted RN license
• 3-5+ years of clinical nursing experience
• Prior utilization management experience with a focus on post-acute care
• Strong clinical assessment and critical-thinking skills
• Ability to work independently while contributing effectively in a team environment
• Detail-oriented with strong organizational and documentation skills
• Comfortable working within multiple computer applications and systems
Preferred
• Experience applying MCG or similar evidence-based clinical criteria
• Background working with health plans or managed care organizations
• Experience collaborating with interdisciplinary clinical and administrative teams
Benefits
Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family's needs. For details, please review the DAHL Benefits Summary: https://www.dahlconsulting.com/benefits-w2fta/. How to Apply
Take the first step on your new career path!To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we've reviewed your application details, a recruiter will reach out to you with next steps! Equal Opportunity Statement
As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!
#BP.Indeed
#ZR
Dahl Consulting is proud to offer a comprehensive benefits package to eligible contract employees that will allow you to choose the best coverage to meet your family's needs. For details, please review our Benefits Summary: www.dahlconsulting.com/benefits-w2fta.
Dahl Consulting is an Equal Opportunity Employer and does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other applicable legally protected characteristics.
Review DAHL & earn up to $100 | www.dahlconsulting.com/review-us
Refer a friend for rewards | www.dahlconsulting.com/careers/refer-a-friend
Apply Now
Apply Now
Title: Utilization Management Nurse - Post Acute
Location: Remote | Candidates must reside within Minnesota or Wisconsin
Job Type: Contract (3 months)
Compensation: $40-45/hr W2
Industry: Health Insurance
---
About the Role
Our client, a well-established healthcare payer headquartered in Minnesota, is seeking a Utilization Management Nurse - Post Acute to support utilization review activities across post-acute care settings. This role plays a critical part in ensuring medically appropriate, cost-effective care by applying clinical judgment, evidence-based criteria, and member coverage guidelines. Job Description
In this role, you will be responsible for reviewing and documenting prior authorization requests and concurrent stays for post-acute services, including skilled nursing facilities, acute inpatient rehabilitation, and long-term acute care hospitals. You will evaluate member case history and determine medical necessity in alignment with established policies, procedures, and clinical criteria (MCG).
The Utilization Management Nurse collaborates closely with members, providers, facilities, medical directors, intake staff, case managers, and internal departments to support timely and accurate utilization decisions. Strong attention to detail, sound clinical judgment, and comfort working across multiple systems are essential for success. Qualifications
Required
• Associate or Bachelor's degree in Nursing
• Active, unrestricted RN license
• 3-5+ years of clinical nursing experience
• Prior utilization management experience with a focus on post-acute care
• Strong clinical assessment and critical-thinking skills
• Ability to work independently while contributing effectively in a team environment
• Detail-oriented with strong organizational and documentation skills
• Comfortable working within multiple computer applications and systems
Preferred
• Experience applying MCG or similar evidence-based clinical criteria
• Background working with health plans or managed care organizations
• Experience collaborating with interdisciplinary clinical and administrative teams
Benefits
Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family's needs. For details, please review the DAHL Benefits Summary: https://www.dahlconsulting.com/benefits-w2fta/. How to Apply
Take the first step on your new career path!To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we've reviewed your application details, a recruiter will reach out to you with next steps! Equal Opportunity Statement
As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!
#BP.Indeed
#ZR
Dahl Consulting is proud to offer a comprehensive benefits package to eligible contract employees that will allow you to choose the best coverage to meet your family's needs. For details, please review our Benefits Summary: www.dahlconsulting.com/benefits-w2fta.
Dahl Consulting is an Equal Opportunity Employer and does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other applicable legally protected characteristics.
Review DAHL & earn up to $100 | www.dahlconsulting.com/review-us
Refer a friend for rewards | www.dahlconsulting.com/careers/refer-a-friend
Apply Now
Apply Now