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Utilization Review (UR) Nurse – RN | Hybrid Role in Washington, DC (Full-Time)

Looking for a role where your clinical expertise directly impacts patient care decisions at a system level? We’re seeking an experienced RN Utilization Review Nurse to join a mission-driven healthcare team supporting long-term care facilities across Washington, DC.

This is a hybrid opportunity that blends onsite clinical review work with remote flexibility—ideal for a nurse who enjoys both field-based assessments and independent analysis.

Why This Role?

This position offers the chance to work closely with healthcare providers, facilities, and interdisciplinary teams to ensure patients receive the right level of care at the right time. You’ll play a key role in improving care quality, compliance, and outcomes across long-term care settings.

Schedule

• Full-time, hybrid role
• Onsite 1–2 days per week visiting different nursing facilities across DC & Maryland
• 2–4 days per week telework (depending on schedule needs)
• Flexible hours between 8:00 AM – 6:00 PM ET
• Candidates must reside in the DMV area

Immediate consideration, send your resume to: AThornton@Nri-staffing.com

What You’ll Be Doing

• Conduct utilization management and quality reviews to evaluate continued need for services and patient acuity
• Review and ensure compliance of care plans and documentation with regulatory standards (PASRR, MDS, Medicare, Medicaid, etc.)
• Perform onsite evaluations at various nursing facilities in Washington, DC and Maryland
• Collaborate with providers and care teams to support appropriate level-of-care decisions

What We’re Looking For

• Strong background in Utilization Review and Quality Improvement
• Experience with Medicare and Medicaid criteria strongly preferred
• Knowledge of PASRR, MDS, and continued stay reviews
• Familiarity with medical management systems (Jiva preferred)
• Strong organizational skills with the ability to manage multiple priorities
• Reliable transportation for onsite facility visits

Required Credentials & Experience

• Nursing or Social Work degree/diploma
• Active, unrestricted RN license in Washington, DC (or ability to obtain within 90 days) OR LICSW
• 2+ years of direct clinical patient care experience
• 2+ years in long-term care admissions screening and care planning
• 1+ year of MDS or utilization review experience preferred
• Must reside in the DMV area

Immediate consideration, send your resume to: AThornton@Nri-staffing.com