Description Summary: The Utilization Management Nurse II is responsible for determining the clinical... approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the...
records supporting services rendered to members for medical necessity and benefit validation. The Utilization Management Nurse..., Senior will report to the Manager, Utilization and Medical Review. In this role you will be performing post service review...
Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management Participation... Medical Director, as needed, for complex cases and make appropriate referrals to downstream partners Apply clinical expertise...
Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management Participation... Medical Director, as needed, for complex cases and make appropriate referrals to downstream partners Apply clinical expertise...
of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the... Improvement/Quality Director. Reviews eligibility and benefits of patients to validate accurate level of care utilization...
and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the... Improvement/Quality Director. Reviews eligibility and benefits of patients to validate accurate level of care utilization...
, Commercial, etc.) 2+ years of utilization management experience Strong knowledge of utilization management processes... clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special...
Your Role The Utilization Management team reviews the inpatient stays for our members and correctly applies the... guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management...
years experience as a Utilization management medical director. Deep knowledge of health plan utilization management... President / Chief Clinical Officer of Utilization Management (UM) is responsible for the overall clinical performance of the...
We are looking for a Utilization Management RN to join us in leading our organization forward. McLaren Integrated HMO... more about MDwise, Inc. at Position Summary: This position is responsible for utilization management functions. This includes...
and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Utilization Management... with Optum Medical Directors on performing utilization management Participation in discussions with the Clinical Services team...
Overview: Now hiring a Utilization Management Reviewer-LTC Responsible for conducting Nursing (NF) Facility Level... utilization/benefit management program, including but not limited to community benefit care plans and self-directed community...
, but not limited to their placement in various levels of care and receipt of necessary services. The Utilization Management... duties. Utilization Review Management - Yale Campus Location: Tulsa, Oklahoma 74136 EOE Protected Veterans/Disability...
Overview Now hiring a Utilization Management Reviewer-LTC Responsible for conducting Nursing (NF) Facility Level... utilization/benefit management program, including but not limited to community benefit care plans and self-directed community...
Job Description: Your Role The Utilization Management team reviews the inpatient stays for our members... and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the...
. The Sr. Manager Medical and Utilization Review will report to the Director Medical and Utilization Review. In this role... in terms of planning, cost and methods in collaboration with Director. Participate in the development and implementation...
they are rendered. The Sr. Manager Medical and Utilization Review will report to the Director Medical and Utilization Review..., department or functional area results in terms of planning, cost and methods in collaboration with Director. Participate in the...
, and clinical outcomes for patients. Works in conjunction with the Medical Director of Utilization Management to lead the medical... operations and strategic planning for the department of Patient Support Services (Case Management) and Utilization Review...
Description Summary: The Utilization Management Nurse II is responsible for determining the clinical... approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the...
Description Summary: The Utilization Management Nurse II is responsible for determining the clinical... approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the...