What You’ll Do - Review patient charts and documentation against defined coverage criteria - Work with internal AI software that enables review productivity - Apply structured processes to determine documentation sufficiency - Identify missing or inconsistent documentation and flag appropriately - Produce clear, standardized written summaries of review outcomes - Meet daily throughput and quality targets (e.g., reviews/day, QA pass rates) - Incorporate feedback from QA and continuously improve accuracy and speed - Collaborate with product team to refine software over time What You'll Bring: The Skills and Experience You’ll Leverage Required: - Active RN license (BSN preferred but not required) - 2+ years of clinical experience OR prior utilization review / documentation review experience - Extremely strong attention to detail - Fast learning rate of new concepts - Ability to follow structured workflows and apply rules consistently - Comfort working in a high-throughput, metrics-driven environment - Strong written communication skills - DME, Medicare regulations/surgical dressing reviews preferred but not required The Rewards & Reality: Compensation, Benefits & Logistics - Meaningful Compensation: $70,000-$90,000 base salary - Comprehensive Health & Wellness: We cover 100% of your health insurance premium and provide access to high-quality dental and vision insurance plans for you and your dependents. - Plan for the Future: We offer a 401(k) plan to help you save for your future. At this time, the company does not offer a 401(k) match. - Career Growth: You'll have opportunities for rapid career advancement in a company that's at a major inflection point. We want you to grow with us. Apply: https://jobs.ashbyhq.com/versemedical/83f1c718-1d73-47ac-85e3-45e290a16f20

CAREER OPPORTUNITY OFFERING: - Bonus Incentives - Paid Certifications - Tuition Reimbursement - Comprehensive Benefits - Career Advancement This position pays: - RN pay scale $39.40 - $53/hr based on experience  - LPN pay scale $32.65 - $46.90/hr based on experience  **Must have current unrestricted LPN or RN compact licensure and willing to obtain single state licensure in Oregon and Alaska​** We are seeking Senior Virtual Utilization Review Specialists in Pacific Time and Mountain Time to join our team. The schedules we are offering include: Weekday work schedule: - Three - 12 hour shifts per week with rotating weekends and holidays - Training will be Monday - Friday, 8 hour shifts Essential job function include: Resource Utilization - Utilizes proactive triggers (diagnoses, cost criteria, and complications) to identify potential over/under utilization of services - Initiates appropriate referral to physician advisor in a timely manner - Understands proper utilization of health care resources and assists with identifying barriers to patient progress and collaborates with the interdisciplinary team - Collaborates with financial clearance center, patient access, financial counselors and/or business office regarding billing issues related to third party payers Medical Necessity Determination - Conducts medical necessity review of all admissions. Utilizes approved clinical review criteria to determine medical necessity for admissions including appropriate patient status and continued stay reviews, possibly from an offsite location - Provides inpatient and observation (if indicated) clinical reviews for commercial carriers to the Financial Clearance Center (FCC) within one business day of admission - Communicates all medical necessity review outcomes to in-house care management staff and relevant parties as needed - Collaborates with the in-house staff and/or physician to clarify information, obtain needed documentation, present opportunities and educate regarding appropriate level of care - Collaborates with the financial clearance center, patient access, financial counselors, and/or business office regarding billing issues related to third party payers

Job Type Full-time Description About Brook Health Brook Health delivers care beyond the walls of the doctor’s office. The company provides people living with chronic conditions a highly personalized experience enhanced by AI and powered by mobile apps, connected devices, and a team of health coaches and clinicians. Brook helps people achieve their long-term health goals by supporting smart, daily decisions and partnering with their primary care physicians. The product suite includes continuous remote monitoring, population health management tools, and a CDC-approved diabetes prevention program. Brook has an intentional, user-centric culture with high expectations for delivering better health outcomes for patients, providers, and health systems. Job Overview The Licensed Practical Nurse (LPN), Remote Nurse Monitor serves as the heart of Brook’s care model—combining clinical expertise with compassion to bring human connection to technology-driven care. The LPN acts as an extension of the provider’s office, monitoring patients’ health data in real time and guiding them through daily decisions that support improved health outcomes. This role builds trusted relationships with patients, helping them interpret their readings, stay engaged in their care plans, and feel supported every step of the way. The LPN collaborates closely with Registered Nurses, Health Coaches, and provider partners to identify early signs of risk, close care gaps, and ensure timely and appropriate interventions. The position is ideal for a nurse who thrives on meaningful patient interaction, embraces innovation, and seeks to be part of a forward-thinking team redefining chronic care delivery through empathy, data, and technology. Requirements Key Responsibilities Patient Onboarding & Education: Introduces new patients to Brook’s remote monitoring program, explains device setup and usage, and ensures each patient feels comfortable and confident participating in their care. Health Monitoring & Data Review: Reviews incoming biometric data and patient-reported information to identify changes in condition, trends, or areas requiring follow-up or escalation.

Job Description: The RN in the Clinical Communication Call Center ensures a superior customer service experience for all who interact with the Clinical Communication Call Center. The RN provides consultation, education, and strategic guidance related to patient questions and health needs via a phone, email, text or other communication method. The Registered Nurse has responsibility to provide accurate, safe and relevant information and support to the patients who are contacting Intermountain for advice or have been recently discharged. Key responsibilities for incoming calls include receiving, triaging and responding to telephone calls/contact from patients and family members. Outbound calls for patients discharged from a hospital, emergency department or outpatient surgical center. Both services will require the ability to assess patients by phone, provide recommendations, offer referral, education and when necessary, direct them to the appropriate level of care. ** Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings. **​ We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: - California, Connecticut, Hawaii, Illinois, New York, Pennsylvania, Rhode Island, Vermont, Washington Posting Specifics - Benefits Eligible: No - Shift Details: PRN - Work week is Monday - Friday 8:00 am - 5:00 pm MST. PRN caregivers are expected to support staff on an as needed basis and help cover - sick calls, vacations, period of increased operational need. PRN Caregivers are expected to attempt to work a minimum of 8 hours per week. Orientation for all PRN staff will be full time, 5 8 hours shifts per week. This orientation period will be a minimum of 2 months or until the caregiver is competent in independent triage.   - Unit/Location: Fully remote. Ideal Candidate would have an Intermountain Health caresite near to them.  - Preferred Qualifications: Experienced RN · Five years of clinical RN experience, with a strong background in emergency nursing, telephone triage, primary care, or medical-surgical nursing, demonstrating well developed assessment and decision making skills. Spanish speaking RN is highly preferred. - Additional Details: This position will be providing triage phone support for Primary Care Clinics throughout the canyons region. Caregivers can expect to be on the phone the majority of their shifts, but will have scheduled breaks. 

As a Clinical Reviewer, Nurse you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients’ lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. Essential Functions• Functions in a clinical review capacity to evaluate all cases , which do not pass the authorization approval process at first call while promoting a supportive team approach with call center staff. Renders authorization approval based on established clinical criteria; escalates to a Field Medical Director (FMD) if authorization cannot be approved during initial review. Clinical Reviewers are supported by FMDs in the utilization management determination process. • Reviews charts and analyzes clinical record documentation in order to approve services that meet clinical review criteria. • Conducts ongoing activities which monitor established quality of care standards in the participating provider network and for other clinical staff. • Converses with medical office staff to obtain additional pertinent clinical history/information; notifies of approvals and denials, giving clinical rationale, while providing optimum customer service through professional/accurate communication and maintaining NCQA and health plans required timeframes. • Documents all communication with medical office staff and/or treating provider. • Practices and maintains the principles of utilization management by adhering to policies and procedures. • Participates in on-going training programs to ensure quality performance in compliance with applicable standards and regulations, as well as, being audited to ensure guidelines are applied appropriately. Required Qualifications • Current, unrestricted state licensure as a Registered Nurse • Associate or Bachelor's in nursing (Must be a Registered Nurse) • Strong interpersonal and communication skills • Proficient computer skills; must be able to talk and type simultaneously • 5+ years clinical experience is preferred • Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an “excluded person” by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. • No history of disciplinary or legal action by a state medical board