3 years of clinical nursing experience At least 2 years of experience in utilization management of sub-acute Medicare..., facilities, and interdisciplinary teams to ensure optimal patient care and resource utilization. Document review outcomes...
3 years of clinical nursing experience At least 2 years of experience in utilization management of sub-acute Medicare..., facilities, and interdisciplinary teams to ensure optimal patient care and resource utilization. Document review outcomes...
3 years of clinical nursing experience At least 2 years of experience in utilization management of sub-acute Medicare..., facilities, and interdisciplinary teams to ensure optimal patient care and resource utilization. Document review outcomes...
. The Clinical Care Reviewer – Utilization Management will also be counted upon to: Conduct utilization management reviews... Care Reviewer – Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring...
Role Overview: The After Hours Behavioral Health (BH) Utilization Management (UM) Reviewer is scheduled to work non... in behavioral health and/or substance use disorder. Managed care and utilization management experience required. Licensure: RN...
) Supervisor, the LTSS Reviewer is responsible for completing care and service needs reviews. Using evidence-based LTSS needs... assessment knowledge and health care/social services licensure experience, the Reviewer reviews the Service Coordinator...
with utilization management nurses and clinical staff to support timely decision-making. Review appeals and grievances related... clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special...
of payer mechanisms and utilization management is preferred. Two years’ experience in acute care and four years clinical...-centered approach and unwavering commitment to compassionate care. We are currently seeking a dedicated Utilization Reviewer...
of payer mechanisms and utilization management is preferred. Two years' experience in acute care and four years clinical...-centered approach and unwavering commitment to compassionate care. We are currently seeking a dedicated Utilization Reviewer...
Job Description: The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring... to determine the necessity and appropriateness of medical procedures, tests, and treatments. Utilization Management Nurse...
The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services... necessity and appropriateness of medical procedures, tests, and treatments. Utilization Management Nurse Reviewers collaborate...
relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the.... Provide reviewer training when a Medical Director is unavailable; escalate issues to Medical Directors when appropriate...
. Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. Processes incoming...Anticipated End Date: 2025-10-24 Position Title: Utilization Management Representative II (California...
Anticipated End Date: 2025-10-24 Position Title: Utilization Management Representative... I Job Description: Utilization Management Representative I Virtual: This role enables associates to work virtually full-time, with the exception...
Anticipated End Date: 2025-10-24 Position Title: Utilization Management Representative I (Idaho...) Job Description: Utilization Management Representative I Virtual: This role enables associates to work virtually full-time, with the exception...
Anticipated End Date: 2025-10-24 Position Title: Utilization Management Representative I (Florida...) Job Description: Utilization Management Representative I Virtual: This role enables associates to work virtually full-time, with the exception...
Anticipated End Date: 2025-10-24 Position Title: Utilization Management Representative I (Idaho...) Job Description: Utilization Management Representative I Virtual: This role enables associates to work virtually full-time, with the exception...
Anticipated End Date: 2025-10-20 Position Title: Utilization Management Representative... I Job Description: Utilization Management Representative I Virtual: This role enables associates to work virtually full-time, with the exception...
Anticipated End Date: 2025-10-20 Position Title: Utilization Management Representative... I Job Description: Utilization Management Representative I Virtual: This role enables associates to work virtually full-time, with the exception...
Anticipated End Date: 2025-10-17 Position Title: Utilization Management Rep I (US) Job Description: Utilization... for employment, unless an accommodation is granted as required by law. The Utilization Management Representative...