Medicare Utilization Review RN — Care Optimization

American Health Plans

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc., is seeking an Utilization Review Nurse to assess medical necessity across pre-service, concurrent, and retrospective reviews. You will support the Clinical Services Department and Medical Director to ensure compliant, high-quality care for members. The role requires an RN license, 1+ year UM experience, and knowledge of InterQual/MCG clinical criteria, with opportunities in a multi-state Medicare #J-18808-Ljbffr American Health Plans

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Vacancy posted 2 days ago

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