Utilization Review Nurse- Remote

Company: Truhealth | Location: Remote, United States | Employment: Full-time | License: RN | State licensure: Not Specified

JOB SUMMARY: The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. The primary role of the Utilization Management (UM) Nurse is to provide clinical support to the Clinical Services Department and Medical Director to assure that members receive all appropriate medical services in compliance with medical and regulatory guidelines.