Remote Utilization Review Rn Jobs in Edgewood, KY

RN Hospice Workflow Specialist / Weekend Manager (Remote)

The RN Hospice Workflow Specialist / Weekend Manager is responsible for overseeing and coordinating hospice clinical operations during weekends while ensuring efficient workflow management, regulatory compliance, and high-quality patient care. This remote leadership role serves as a key resource for clinical staff, provides operational oversight, supports interdisciplinary team communication, and facilitates timely patient care interventions across the hospice program.

The ideal candidate is an experienced Registered Nurse with hospice expertise, strong clinical judgment, excellent organizational skills, and the ability to effectively manage multiple priorities in a remote environment.

• Provide remote leadership and oversight of hospice clinical operations during weekends and designated after-hours periods.

• Monitor daily workflow, staffing coverage, patient census, and clinical priorities.

• Coordinate and manage urgent patient care needs, admissions, recertifications, discharges, and death visits.

• Ensure timely triage and response to patient, family, and referral source concerns.

• Support field clinicians in complex clinical decision-making and symptom management.

• Manage and optimize weekend clinical workflows to ensure continuity of care.

• Review and prioritize incoming referrals, physician orders, and clinical documentation.

• Monitor EMR work queues and ensure completion of critical tasks.

• Coordinate communication among nurses, social workers, chaplains, physicians, and other interdisciplinary team members.

• Identify workflow barriers and implement solutions to improve efficiency and patient outcomes.

• Serve as the primary clinical resource for weekend staff.

• Provide guidance regarding hospice eligibility, regulatory requirements, documentation standards, and care planning.

• Escalate significant clinical concerns to executive leadership and medical directors as appropriate.

• Support staff development through coaching, mentoring, and problem-solving assistance.

• Ensure compliance with Medicare Conditions of Participation, state regulations, accreditation standards, and organizational policies.

• Review clinical documentation for completeness, accuracy, and timeliness.

• Monitor quality indicators and address identified issues promptly.

• Participate in quality improvement initiatives and process enhancement projects.

• Maintain effective communication with patients, families, referral sources, physicians, and internal departments.

• Facilitate seamless transitions of care and coordination among team members.

• Provide detailed handoff reports to weekday leadership teams.

• Participate in meetings, case reviews, and operational planning activities as required.

• Active, unrestricted Registered Nurse (RN) license.

• Minimum of 3 years of hospice nursing experience.

• Minimum of 1 year of leadership, supervisory, or care coordination experience.

• Strong knowledge of hospice regulations, Medicare guidelines, and end-of-life care practices.

• Experience using electronic medical record (EMR) systems.

• Excellent communication, critical thinking, and organizational skills.

• Ability to work independently in a remote environment.

• Reliable internet connection and dedicated home workspace.

• BSN preferred.

• CHPN (Certified Hospice and Palliative Nurse) certification preferred.

• Experience with multi-site hospice operations.

• Previous experience in remote clinical management or workflow coordination.

• Clinical Leadership

• Hospice Regulatory Knowledge

• Workflow Optimization

• Staff Support and Coaching

• Patient-Centered Care

• Time Management

• Critical Thinking

• Conflict Resolution

• Interdisciplinary Collaboration

• Documentation Excellence

• Remote position.

• Primarily weekend coverage (Saturday and Sunday), with flexibility for holidays and occasional weekday support as needed.

• Availability for on-call consultation and urgent operational issues during assigned shifts.

• Ability to sit, use a computer, and communicate via phone and video conferencing for extended periods.

• Ability to review electronic clinical records and documentation.

• Occasional travel may be required for training, meetings, or organizational events.

• Competitive salary based on experience.

• Health, dental, and vision insurance.

• Paid time off and holiday pay.

• Retirement savings plan.

• Continuing education and professional development opportunities.

• Certification reimbursement and leadership growth opportunities.