Healthcare Review Specialist

2 weeks ago


SaintAubinsurGaillon, Normandie, United States Brighton Health Plan Solutions Full time

Brighton Health Plan Solutions is seeking a skilled Utilization Management Nurse to join our team. As a key member of our prior authorization team, you will play a critical role in ensuring that our members receive the care they need.

In this role, you will perform medical necessity reviews on prior authorization requests, working closely with healthcare partners to ensure timely review of services and care. You will also identify potential Third-Party Liability and Coordination of Benefit Cases and notify appropriate parties/departments.

To succeed in this role, you will need to have a strong background in nursing, with current licensure as an LPN or RN. Proficiency in Microsoft Office is also required, as well as the ability to work independently and adapt to a high-paced environment.

We offer a competitive salary range of $65,000 - $85,000 per year, based on experience. Our comprehensive benefits package includes health insurance, retirement savings, and paid time off.

If you are a motivated and detail-oriented nurse looking for a new challenge, we encourage you to apply for this exciting opportunity.



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