RN Utilization Review Specialist
American Health Plans Inc.
American Health Plans in Franklin, TN seeks an Utilization Review Nurse to assess medical necessity and quality of care for plan members. You will support the Clinical Services Department and Medical Director to ensure services comply with regulatory guidelines. The role requires RN licensure and UM experience; knowledge of Interqual/MCG and Medicare regulations is essential. Collaborative team environment, with focus on patient care coordination and regulatory compliance. #J-18808-Ljbffr
Vacancy posted 8 hours ago
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