Pride Health is seeking an experienced Registered Nurse (RN) with Utilization Management experience to support clinical quality review and AI model development for prior authorization use cases. The ideal candidate will review records, apply InterQual/MCG criteria, and lead calibration sessions to ensure consistent application of guidelines and improve annotation accuracy for AI models.
The role requires Minnesota RN licensure, 3+ years in UM or prior authorization, strong CPT/HCPCS and ICD-10
#J-18808-LjbffrRemote Utilization Review RN - AI & Prior Authorization in workfromhome at Unknown Company
- Typical pay
- $75,660–$135,200
For context, most registered nurses earn between $75,660–$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.