Healthcare Transformation Specialist

7 days ago


Atlanta, Georgia, United States Sidecar Health Full time

About Us

Sidecar Health is a pioneering health insurance company that aims to make high-quality healthcare accessible and affordable for everyone.

We are looking for talented individuals who share our mission to transform the healthcare industry in the United States.

Salary Range

The estimated salary for this position is $80,000 - $95,000, depending on location and job-related skills and experience.

Job Description

As a Utilization Review Nurse at Sidecar Health, you will play a crucial role in evaluating the medical necessity and quality of healthcare services for our members.

You will review medical records, ensure compliance with established clinical guidelines and policies, and collaborate with healthcare providers to gather additional information when needed.

Key Responsibilities

  • Review and analyze medical records to assess the appropriateness and necessity of healthcare services
  • Ensure compliance with established clinical guidelines, policies, and regulatory requirements
  • Collaborate with healthcare providers to gather additional information when needed
  • Utilize Milliman Care Guidelines (MCG) to evaluate the medical necessity and appropriateness of proposed and ongoing treatments
  • Evaluate good faith estimates and


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