Registered Nurse – Utilization Review, Per Diem

HonorHealth

. Review and monitor utilization of health care services to maintain high-quality, cost-effective care .

Posted 9/29/2026part-timeRemote • Arizona • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Utilization Review and Case Management, ensuring high-quality, cost-effective care through comprehensive medical-necessity reviews and collaboration with healthcare teams. Proficient in clinical documentation review and quality-outcome reporting to optimize service delivery.

Highest-signal resume keywords

Utilization Review (UR)Case ManagementRegistered Nurse (RN) LicenseMedical-Necessity ReviewCertified Case Manager (ACM)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Documentation ReviewMedical-Record ReviewPatient Admission AssessmentQuality-Outcomes ReportingDRG Classification Identification

Soft Skills

CollaborationCommunicationProblem-Solving

Certifications & Qualifications

Certified Case Manager (ACM)

Industry Keywords

Health Care ServicesCost-Effective CareAcute Care SettingMedicareAHCCCS

About the role

Key responsibilities & impact

Review and monitor utilization of health care services to maintain high-quality, cost-effective care
Ensure the appropriate level of care through comprehensive medical-necessity reviews of extended stays, outpatient observation, inpatient stays, and ancillary services
Coordinate and conduct medical-necessity reviews for Medicare, AHCCCS, self-pay, and other payers upon admission and concurrently throughout admission
Review clinical documentation and facilitate modifications to accurately reflect level of service and severity of illness
Perform initial and concurrent reviews for patients entering the health care continuum
Facilitate service delivery through effective utilization of available resources
Perform medical-record reviews as required by payers
Provide Care Management with quality-outcome information
Collaborate with physicians, case managers, payers, medical records, finance, and physician groups on denials, contract guidelines, documentation, and data reporting
Initiate chart reviews, conduct follow-up reviews, and round on patients for continuity of utilization-review reviews
Identify admissions with specific diagnoses, DRG classifications, or other categories
Notify physicians and staff about documentation issues requiring clarification
Determine qualifications for hospital-level care based on established criteria
Perform other duties as assigned

Requirements

What you’ll need

Seeking applicants who can work at least 8 shifts per month
Associate's in Nursing from an accredited NLN/CCNE institution required, or Bachelor's in Nursing from an accredited NLN/CCNE institution preferred
1 year of experience in UR/UM or Case Management required
3 years as a Registered Nurse in an acute care setting required
Registered Nurse (RN) license in the state and/or compact state licensure required
Certified Case Manager certification (ACM) preferred

Benefits

Comp & perks

Per diem employment
Day shift
Career development opportunities