About the job
We’re Hiring: Utilization Management Registered Nurse (Remote, U.S.)
Join a team committed to clinical excellence, integrity, and patient-centered authorizations. BroadPath is seeking a Utilization Management RN to review authorization requests, apply clinical criteria, and ensure that our members receive high-quality, timely care. You’ll work remotely while collaborating with peers and leadership to maintain compliance and deliver outstanding outcomes.
What You’ll Do
- Review and process authorization requests using clinical guidelines and medical necessity criteria
- Coordinate with providers and internal teams to obtain required documentation and ensure accurate adjudication
- Analyze medical records, diagnoses, and treatment plans to support consistent, evidence-based decisions
- Monitor trends and identify opportunities for process improvements and cost efficiencies without sacrificing quality
What We’re Looking For
- Current Registered Nurse (RN) licensure in the U.S.
- Strong understanding of utilization management, medical necessity, and clinical criteria
- Excellent clinical documentation review skills and the ability to make sound decisions based on medical records
- Ability to work independently in a remote setting, while collaborating across teams
Why BroadPath?
- Fully remote work opportunity
- Culture of professional growth, clinical excellence, and accountability
- Meaningful impact on patient care and outcomes
If you’re an experienced RN who thrives in a remote, data-driven environment and wants to help ensure members get the care they need, we’d love to hear from you.