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 InterQual/MCG clinical criteria, with opportunities in a multi-state Medicare
#J-18808-LjbffrMedicare Utilization Review RN — Care Optimization in franklin at Unknown Company
- Typical pay
- $84,500–$135,200
For context, most registered nurses earn between $84,500–$135,200 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as full time and onsite.