Utilization Review Nurse: Care Quality Advocate
American Health Partners
American Health Plans, a division of American Health Partners Inc., is seeking an experienced Utilization Review Nurse to support the Clinical Services Department in Franklin, Tennessee. You will assess medical necessity, quality of care, and appropriate level of care for plan members, using InterQual or MCG criteria. Collaborate with the Medical Director and providers, perform pre-service, concurrent, and retrospective reviews, and ensure compliance with regulatory timelines while delivering #J-18808-Ljbffr American Health Partners
Vacancy posted 2 days ago
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