for all utilization review activities. Interact with medical, nursing, and executive leadership to facilitate quality based, cost... in the areas of utilization criteria, appeal and review process, and case management system documentation. Conduct hiring...
efficiency and quality improvement goals. Requirements Licensure / Certification / Registration: Registered Nurse... Lead and oversee RN case managers to ensure high-quality patient care and effective care coordination. Direct utilization...
and coordinates care to ensure highest quality care for client's disease state. Utilizes clinical skills to review and monitor... utilization of health care services with the goal of maintaining high quality cost-effective care while engaging and empowering...