Utilization Management Nurse
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 3 days ago
Similar jobs that could be interesting for youBased on the Utilization Management Nurse in Chapel Hill, NC vacancy
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Brighton Health Plan Solutions, LLC
Chapel Hill, NCa month ago - Brighton Health Plan Solutions, LLC is seeking an Utilization Management Nurse to perform medical necessity reviews remotely. Licensed LPN with strong MS Office skills will review clinical criteria, coordinate with care partners, and document determinations in compliance...SuggestedRemote job
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Chapel Hill, NC4 days ago
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