management experience in pharmacy, medical/surgical, or psychiatric, preferably in the health insurance industry. Professional...Note, this is a fully remote opportunity in Ohio. Founded in 1934, Medical Mutual is the oldest and one of the...
Overview: Medicare Medical Review RN (Medical Reviewer III) - REMOTE The Medicare Medical Review RN (Medical... Reviewer III) will primarily be responsible for conducting clinical reviews of medical records during the course of fraud...
that have a strong clinical utilization management background. Medicare experience is a plus. Founded in 1934, Medical Mutual is the oldest... management experience, preferably in the health insurance industry. Acute care Medical/Surgical/Critical Care and ambulatory...
and or utilization/case management experience, preferably in the health insurance industry. Acute inpatient level of care in Medical...Under limited supervision, applies medical necessity guidelines in making authorization determinations for inpatient...