It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness of services, following clinical criteria, coverage policies, and contract guidelines. This involves reviewing medical documentation, accurately documenting findings, and ensuring policy compliance. Your role in our mission Review admissions, procedures, services, and supplies for medical necessity and appropriateness, meeting quality and production goals. Use clinical criteria for decision-making, referring complex cases to Medical Directors when needed. Engage with providers to gather clinical information, apply guidelines, and make determinations. Document findings and rationale in medical management systems. Assist in training new nurses, provide feedback, and stay updated on clinical guidelines. Maintain RN license and meet continuing education requirements. What we're looking for Active RN license. 3+ years of inpatient clinical experience. 1+ year in prior authorization reviews using InterQual or MCG. Strong written communication skills in a fast-paced setting. Proficient in Microsoft Office and other computer applications. What you should expect in this role Home-based position. High-speed internet and a distraction-free workspace required. Core hours: 8:00 AM - 6:00 PM ET, with potential for extended hours. Occasional travel (up to 10%) based on business needs. This position is for pipeline purposes, and we welcome applications on an ongoing basis. #LI-AC1 #LI-REMOTE The pay range for this position is $65,000.00 - $78,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Overview Position: Registered Nurse (RN) Location: Durham, NC Schedule: 7 p.m. - 7:30 a.m.Compensation: $39.38 to $53.00 per hour Sign-on bonus: $10,000 Select Specialty Hospital - Durham is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives – and Registered Nurses (RNs) play a central role in providing compassionate, excellent treatment every step of the way. At our company, we support your career growth and personal well-being. Start Strong : Extensive and thorough Registered Nurse (RN) orientation program to ensure a smooth transition into our setting. Advance Your Career :100% company-paid scholarship (BSN), tuition reimbursement, and continuing education. Elevate Your Skills : Clinical ladder program and certifications such as PCCN and CCRN. Ease the Burden : Student Debt benefit program. Recharge & Refresh : Generous PTO for full-time team members to maintain a healthy work-life balance Your Health Matters : Comprehensive medical/RX, health, vision, and dental plan offerings for full-time team members Invest in Your Future: Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care Responsibilities Receive admissions and/or transfers to the unit Initial and ongoing systematic patient assessment Timely and accurate documentation using appropriate systems Interpret assessment/diagnostic data including labs and telemetry Ensure medical orders are transcribed and processed accurately Competence in Rapid Response and code events Instruct and counsel patients/families Performs other duties as assigned Qualifications Minimum Qualifications: Valid State Registered Nurse (RN) License BLS is required at hire. ACLS is required within 6 months of hire Preferred Qualifications: Clinical experience Additional Data Equal Opportunity Employer/including Disabled/Veterans
