Use your clinical expertise to support high-quality, cost-effective care for older adults across the country. This remote role is ideal for nurses experienced in utilization review, discharge planning, and care coordination who want to improve patient outcomes in value-based care.
About Curana Health
Curana Health partners with senior living and skilled nursing communities to deliver value-based care models that improve resident health, streamline operations, and support long-term system stability. Serving 200,000+ seniors across 32 states, the organization blends compassionate clinical care with innovative healthcare programs designed for aging adults.
Schedule
- Full-time, remote (U.S. based)
- Standard business hours
- One weekend day per month
What You’ll Do
- Perform concurrent, retrospective, and prior-auth reviews for hospital, SNF, and home care services
- Monitor medical necessity, quality of care, and cost-effective resource use
- Determine appropriate care levels (observation vs inpatient)
- Lead proactive discharge and transition planning with providers and facilities
- Prepare CMS-compliant notifications and non-certification communications
- Document all communications and maintain accurate records
- Collaborate with physicians, case managers, and interdisciplinary teams
- Identify high-cost cases and escalate quality-of-care concerns
- Support chronic care and improvement program referrals
- Provide benefit clarification to members and providers
What You Need
- Active, unrestricted RN or LPN/LVN license
- 2+ years clinical nursing experience
- 1+ year utilization management or managed care experience preferred
- Skilled in concurrent review, discharge planning, and transition coordination
- Medicare Advantage knowledge preferred
- Familiarity with InterQual or MCG criteria preferred
- Strong organizational, communication, and critical thinking skills
- Comfortable working independently in a remote review environment
Benefits
- Mission-driven organization improving senior care
- Grow with a rapidly expanding healthcare leader
- Collaborative and supportive medical management team
- Remote work flexibility
- Paid time off, holidays, and benefits package (based on eligibility)
Bring your clinical background into an impactful remote utilization management role and help ensure seniors receive the right care at the right time.
Happy Hunting,
~Two Chicks…