Utilization Review Nurse: Elevate Care Quality & Outcomes

TruHealth

American Health Plans, a division of American Health Partners Inc., seeks a Utilization Review Nurse to assess medical necessity and quality of care for plan members. You will support the Clinical Services Department and Medical Director in ensuring services comply with medical and regulatory guidelines. Responsibilities include evaluating level of care, coordinating with providers, and applying criteria to certify or escalate cases. Requires RN license; CCM credential is a plus. #J-18808-Ljbffr TruHealth

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Vacancy posted 4 days ago

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