Remote Utilization Review Jobs in Spring, TX (NOW HIRING)

Compensation:$80,000 - $85,000 annual salary, plus annual potential for bonus and merit increases

Employment Type: Full-Time, Salaried, Exempt

Reports to: Director of Oncology and Infusion

Location: US; fully remote with minimal travel

Schedule: Mostly standard business hours, with some flexing to support members in every US time zone

Renalogicisdedicated tohelping our clients manage the human and financialcostsofchronic kidney disease.To help usinour mission,wehirepeople who are humble, hungry, and smart. And it sure helps if you have a sense ofhumor.We're not perfect, but we're trying to build a company that we are all proud of. Our 96% client retention suggests we're on the right path.

As the Clinical Nurse Navigator (RN), you'll serve as the primary Nurse for oncology care navigation, coordination, guideline-based treatment oversight, symptom assessment, escalation, and survivorship planning. You'll function across the full cancer continuum and provide clinical leadership to ensure care delivery is evidence-based, safe, member-centered, and cost-conscious.

Overall, this role encompasses advanced clinical oversight, pathway alignment, interdisciplinary coordination, and escalation authority to providers. The RN inherits and expands upon all Clinical Nurse Coordinator (LPN) responsibilities.

Some important disclaimers: You'll need to be able to work a flexible schedule to meet member needs, which may include early mornings, evenings, and occasional weekends. The flexibility is particularly important when supporting members in different time zones, where availability may fall outside of traditional business hours. You'll also need to be comfortable using work-approved communication tools, including phones, for occasional after-hours calls or texts. We emphasize work-life balance, and flexible scheduling supports both employee well-being and timely member access to personalized support.

• Establish and maintain contact with assigned oncology members via phone, text, email, and video calls.
• Initiate nursing care plans, educating members on treatment regimens, symptom management, side effects, and disease-specific program benefits.
• Obtain and use clinical information to develop individualized member and clinician-centered care plans that complement oncologist guidance/plan of care.
• Utilize motivational interviewing to empower members, support adherence, and encourage enrollment of new or inactive members in employer-sponsored programs.
• Coordinate care among providers, pharmacies, and support services; facilitate access to medications, infusion services, and financial assistance programs.
• Identify and educate members eligible for clinical trials or therapy adjustments, coordinating logistics with providers and sponsors.
• Monitor adherence, side effects, and treatment response; escalate issues when needed to support physician-directed care.
• Provide emotional support and connect members to counseling, support groups, and survivorship resources.
• Document, request, and send member information per HIPAA; track interactions and outcomes in the EHR.
• Meet assigned metrics, including call volume and enrollment requirements; adapt approaches using multiple communication channels.

• RN license in good standing within a compact state and willingness to pursue additional state nursing licenses as required
• A minimum of 4 years' RN experience with clinical experience in oncology required.
• Experience with infusions or critical care, including care navigation, treatment support, and/or complex case management is strongly preferred.
• Must be able to work a flexible schedule to support members in all US time zones.
• Must be able to speak, write, and communicate fluently in English.
• Ability to speak and write Spanish fluently is a big plus, but not required.
• Utilization Review and/or Care Management preferred.
• Experience working 100% remote as a nurse is highly preferred.
• Ability and willingness to travel occasionally, which will include overnight stays for corporate gatherings, conferences, and health fairs.
• Ability to attend and professionally engage in video meetings.
• Proficient technological skills, meaning you can effectively and efficiently use computers, peripheral equipment, and applications/systems, including Microsoft products.
• Autonomous self-starter who is comfortable with ambiguity.
• Creative mindset and ability to appropriately challenge the status quo.
• Superb written and oral communication skills.
• Ability to overcome obstacles with a yes if...' approach.
• Ability to effectively balance competing deadlines without losing focus on the bigger picture.
• Reliable internet and power with a designated area to conduct work with minimal interruptions.

• Market competitive salary, including potential annual merit increases and bonuses contingent on the company's fiscal performance.
• Generous time off and paid holidays because we value recharging.
• Exceptional healthcare coverage, with the majority of medical, dental and vision premiums covered by us.
• 401k with generous employer match.

We are proud to be an equal opportunity employer, which means that our employment decisions are inclusive and welcoming, regardless of race, gender, age, color, sexual orientation, gender identity, pregnancy status, religion, national origin, disability, or any other personal, physical, mental, or sensory traits. All individuals who are offered a position must successfully pass a background and reference check prior to their start. All individuals must demonstrate they are legally authorized to work in the United States without sponsorship.