Remote Utilization Management Nurse (RN)

Cambia Health is seeking an Utilization Management Nurse who can conduct prospective, concurrent, and retrospective reviews to ensure medical necessity and proper care pathways. You will apply evidence-based criteria and consult with physicians as needed.

In this role, you will collaborate with case management and other departments, support transitions of care, and maintain compliant, accurate documentation while serving members, providers, and regulatory bodies.