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Remote Utilization Management Nurse - Clinical Review

Brighton Health Plan Solutions

Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful candidate will collaborate with healthcare partners, triage cases, and prepare determinations for medical director oversight, ensuring regulatory compliance and quality standards are met. #J-18808-Ljbffr

Vacancy posted 4 days ago
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