To support a growing healthcare organization, the full-time RN Utilization Review Nurse will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care decisions. Key responsibilities Evaluate requested services against benefit language and medical policy to determine appropriate levels of care Route cases that do not meet criteria to the Medical Director for secondary clinical review Document reviews and outcomes in UM systems in real time to maintain a clean audit trail Required qualifications Current, unrestricted RN license in the United States or a U.S. territory Graduate of an accredited nursing program (ADN or diploma required; BSN preferred) 1-2+ years of recent clinical experience in acute care, med-surg, ICU/ED, or a similar setting Utilization review/utilization management experience preferred Proficiency with Microsoft Word, Excel, and Outlook