Description
Guidehealth is hiring a Utilization Management Registered Nurse to perform precertification and concurrent utilization reviews, apply medical necessity criteria, document clinical findings, communicate determinations, collaborate with providers and medical directors, support care coordination and quality initiatives, and maintain regulatory and confidentiality compliance. The role requires an active and unrestricted Illinois RN license, three years of experience in varied healthcare settings, knowledge of utilization review and managed care, and strong clinical judgment and communication skills. It is fully remote, pays $70,000 to $75,000 annually, and includes medical, dental, vision, retirement, life and disability insurance, paid time off, parental leave, and other benefits.
