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Utilization Review RN — Transform Care & Compliance
Job in
Franklin, Williamson County, Tennessee, 37068, USA
Listed on 2026-08-22
Listing for:
American Health Partners
Full Time
position Listed on 2026-08-22
Job specializations:
-
Nursing
RN Nurse
Job Description & How to Apply Below
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 to ensure compliant services.
Responsibilities include evaluating care levels, coordinating with providers, applying review criteria, and certifying cases while meeting regulatory timelines. RN license required; CCM a plus.
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