Medicare Utilization Review RN — Care Optimization
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Nursing
RN Nurse, Healthcare Nursing
Job Description & How to Apply Below
American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc., is seeking an Utilization Review Nurse to assess medical necessity across pre-service, concurrent, and retrospective reviews. You will support the Clinical Services Department and Medical Director to ensure compliant, high-quality care for members.
The role requires an RN license, 1+ year UM experience, and knowledge of Inter Qual/MCG clinical criteria, with opportunities in a multi-state Medicare
We invite applications for the Medicare Utilization Review RN — Care Optimization position located in Franklin, TN, United States.
Please review the full job details above before applying.
If your experience matches this role, we encourage you to apply.
All applications are reviewed carefully by our team.
The position is based in Franklin, TN, United States.
This opportunity is part of our work in Bio & Pharmacology & Health.
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