Utilization Review Clinician - RN, PT, or OT - Remote

WellSky  ยท  via Telehealth Nurse Network
๐ŸŒŽ Remote ๐Ÿ“ Remote | Employment: Full-time |โ€ฆ โฐ Full Time

Company: WellSky | Location: Remote | Employment: Full-time | License: Multiple | State licensure: Not Specified

*This role will require the successful candidate to work the shift of Monday to Friday, 1pm to 10pm Central (2pm to 11pm Eastern). The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This includes conducting patient evaluations, managing admissions and informational visits, and ensuring timely post-discharge follow-ups with completed assessments to help prevent acute care readmissions. In this role, you will also review requests for post-acute services promptly, using established clinical guidelines and coverage criteria to assess appropriateness. Youโ€™ll collaborate with physicians, healthcare providers, and both internal and external stakeholders to support improved health outcomes. By applying clinical expertise, youโ€™ll coordinate