Utilization Management RN – Clinical Review & Cost Control
Listed on 2026-09-22
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Nursing
Clinical Nurse Specialist, RN Nurse
Youritrecruiter UM Nurse role involves conducting clinical reviews to assess medical necessity and efficiency of services requested by providers and members. It supports the health plan’s utilization management aligned with clinical guidelines and accreditation standards.
The position uses criteria such as MCG and Inter Qual for inpatient, outpatient, and ancillary reviews, aiming to deliver cost-effective, high-quality care and regulatory compliance.
Consider building your career as a Utilization Management RN – Clinical Review & Cost Control at Youritrecruiter.
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