Seeking a Registered Nurse (RN) for Utilization Review responsible for assessing, coordinating, and managing long-term services for members with complex medical needs. Key duties include conducting comprehensive in-home assessments, developing individualized care plans, coordinating services and referrals, monitoring member progress, ensuring documentation compliance, and collaborating with providers and caregivers. The role requires an active RN license, a bachelor’s degree in nursing or related healthcare field, and 2-6+ years of clinical or care management experience, preferably in hospital case management, home health, or LTSS. Strong communication, assessment, and care coordination skills are essential to promote quality, cost-effective healthcare outcomes. The position offers competitive pay and involves day shifts, focusing on delivering comprehensive, patient-centered care.