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Remote Utilization Management Nurse - Clinical Review
Remote / Online - Candidates ideally in
Chapel Hill, Orange County, North Carolina, 27517, USA
Listed on 2026-07-14
Chapel Hill, Orange County, North Carolina, 27517, USA
Listing for:
Brighton Health Plan Solutions
Remote/Work from Home
position Listed on 2026-07-14
Job specializations:
-
Nursing
Healthcare Nursing
Job Description & How to Apply Below
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.
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