Responsibilities:

- Perform initial admission and continued stay reviews utilizing InterQual and MCG using evidenced-based criteria to identify and support the appropriate level of care

- Abstract data from a variety of medical records to ensure accurate clinical data

- Adhere to established quality, timeliness, and productivity outputs required in the completion of first-level nursing utilization review

- Ensure effective communication internally and externally while delivering excellent customer service

- Perform other duties as assigned by departmental leadership in support of departmental and organizational strategies and goals, which may include system testing, training, and other opportunities that promote growth

- Complete and maintain annual compliance and annual HIPAA training

- Participate in organizational educational offerings and required training as needed to support service delivery

Required Qualifications:

- Must have a current Registered Nurse license in your state of residence

- Bachelor’s Degree

- At least 2 years of recent hospital-based Utilization or Case Management Experience is preferred

- At least 3 years of clinical nursing experience (practice)

- Knowledge of current Medicare rules and regulations related to Utilization Review

- Strong analytical, organizational and time management skills

- Ability to work independently with limited supervision





- Excellent written and verbal communication skills

- Excellent clinical abstraction and attention to detail

- Experience with InterQual and/or MCG is preferred

- Must be willing to work a variable schedule that encompasses evenings, days, weekends, and holidays (Coverage Hours: 7:00 AM-12:00 AM EST)

For this US-based position, the base pay range is $65,478.00 - $96,885.29 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

This job is eligible to participate in our annual bonus plan at a target of 10.00%

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a

R1 RCM Inc. (“the Company”)

📌 Utilization Review (UR) Author - RN Required (Argentina)
🏢 R1 RCM
📍 Argentina