Utilization Review Nurse

Company: Medix
Location: Washington
Posted on: January 30, 2026

Job Description:

Job Description Job Description Position Overview: Job Title: Utilization Management Review Nurse Location: MLK Avenue Office - 4 days onsite, 1 remote day Salary: $46.00/hour (Willing to negotiate depending on the extent of relevant experience) Work Schedule: Monday-Friday (8:00am - 5:00pm) Position Overview: We are seeking an experienced and motivated Registered Nurse to join our Utilization Management team, specializing in home care reviews . This role plays a vital part in ensuring the accuracy and quality of care plans and service hour determinations for long-term care enrollees. Candidates must have strong clinical backgrounds, advanced computer skills, and demonstrated proficiency in InterQual assessments. Key Responsibilities: Review and evaluate care plans for home care patients Use InterQual criteria for private duty nursing assessments Conduct annual long-term care reviews to adjust services based on enrollee needs Participate in large team rounds (20-30 staff), providing clinical input and collaborating on care decisions Accurately document assessments in EMRs, especially Guiding Care Top Selling Points: Meaningful Work: Directly impacts patient outcomes by assessing appropriate care levels and service hours Hybrid Flexibility: 4 days onsite, 1 remote day of your choice Collaborative Team Environment: Participate in multidisciplinary rounds with a dynamic and supportive team Contract-to-Hire Model: Clear path to permanent placement if both parties are aligned Stability: Consistent pay and hiring structure based on previous success in similar roles Required Qualifications: Licensed Nurse in Washington, DC (ASN, BSN, or LPN with RN credentials) Ideally 1- 2 years of Utilization Management experience Proficient with EMR systems (especially Guiding Care ) Previous experience with Interqual guidelines or willingness to learn Preferred Qualifications: Bachelor's Degree in Nursing (BSN) Previous experience with health plans or managed care organizations (MCOs) Key Soft Skills: Excellent attention to detail and critical thinking Strong time management and ability to meet review deadlines Collaborative mindset and willingness to engage in multidisciplinary team discussions Patience and empathy when reviewing sensitive cases Comfortable working in a hybrid clinical and administrative role Interview Process: Interviews are currently being scheduled. The process includes a standard interview and may involve team interaction to gauge fit. If you have any questions about the information provided above, please feel free to apply to this role and I will follow up with you shortly after to discuss the role and provide you with a more detailed job description. Thank you, Ryan Jacobs For California Applicants: We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA). This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients. Company Description Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine. Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us? Company Description Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Keywords: Medix, Rockville , Utilization Review Nurse, Healthcare , Washington, Maryland