Remote Utilization Management RN — Data-Driven, Impactful Care

Guidehealth, a data-powered healthcare company, seeks a Utilization Management Registered Nurse (RN) to perform utilization review remotely. The role supports compliance with federal and state regulations and URAC standards, applying medical necessity criteria to documentation from medical records for determinations.

You will collaborate with the Medical Director and Peer Reviewers, communicate determinations to providers and members, and integrate AI into daily workflow while maintaining

Join us at Guide-Health as our next Remote Utilization Management RN — Data-Driven, Impactful Care in Gary, IN, United States.

Our team is growing, and we are hiring a Remote Utilization Management RN — Data-Driven, Impactful Care in Gary, IN, United States.

This position is for the Remote Utilization Management RN — Data-Driven, Impactful Care role at Guide-Health.

We are seeking a motivated Remote Utilization Management RN — Data-Driven, Impactful Care to join Guide-Health in Gary, IN, United States.