Remote Utilization Management RN
Guidehealth
Gary, IN
- Remote job
Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments, and ensuring timely decisions in a remote work environment. Ideal candidates hold an active IL RN license, have 3+ years in healthcare settings, and are proficient with Microsoft 365. #J-18808-Ljbffr Guidehealth
Vacancy posted 1 day ago
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