Remote Utilization Management RN Clinical Review Leader

Guidehealth is seeking a Utilization Management Registered Nurse (RN) for a fully remote, full-time position. The role involves applying medical necessity criteria to reviews, documenting findings, and interfacing with providers and members to ensure timely, compliant determinations.

Illinois license active and 3+ years clinical experience preferred. Responsibilities include collaboration with Medical Director, AI workflow integration, and participation in quality initiatives.