All Care To You is seeking a UM Outpatient Review Nurse to join our Case Management team. This remote role emphasizes clinical review, medical necessity determinations, and collaboration with health plans, providers, and members to support high-quality patient outcomes.
You will apply CMS, NCQA, and clinical guidelines to determine coverage, maintain high interrater reliability, and meet turnaround times for urgent and routine reviews.
#J-18808-LjbffrRemote Utilization Review Nurse - Outpatient in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.