Utilization Management RN (Part-Time)

Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges. Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it. That’s Impresiv!

Schedule: part-time hours, every Saturday and Sunday 10 hour shifts OR Friday, Saturday, and Sunday 6 hour shifts Description: We are seeking a detail-oriented and collaborative Utilization Management RN to join a high-performing team. The ideal candidate brings strong clinical judgment and experience with concurrent and preservice review. This role offers the opportunity to contribute to process improvements and support the successful transition to Zyter/TruCare, a new utilization management platform.

Conduct concurrent, preservice, and occasional post-service reviews for medical necessity and coverage using MCG or InterQual. Evaluate services across inpatient, outpatient, SNF, and pharmacy (e.g., specialty infusion). Ensure timely documentation and compliance with state-specific turnaround time (TAT) standards. Accurately document determinations in Zyter/TruCare and contribute to ongoing workflow refinement. Work closely with medical directors, care managers, and other team members to coordinate care.