offer. Responsibilities Manage effective utilization review processes, including management of patient statusing processes and monitoring... programs and key performance indicators for all utilization review activities. Interact with medical, nursing, and executive...
but not limited to: Access Authorization and pre-certification, utilization review and denial management, Care Coordination... of utilization criteria, appeal and review process, and case management system documentation. Develop staff schedule and revises...
. Assists manager as required. Mentors and reviews work of Coding Edit Specialist, Coding Specialist I and Coding Specialist II... related to coding projects done by Coding Specialist I and Coding Specialist II to include review and correction of code...