, qualifications and comparison with associates in similar roles 2 years Utilization Review experience preferred. Effective... communication with healthcare providers, patients, and insurance companies to explain utilization review decisions. Familiarity...
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...
Authorization and pre-certification, utilization review and denial management, Care Coordination, Collaborative treatment... assigned Registered Nurse (RN) case managers, related activities and workflow to ensure effective and efficient patient care...
, such as equipment maintenance, scheduling, supply utilization monitoring etc. Leads NEST based peer review processes. Leads.... Under the direction of the Nurse Manager, the RN will work in conjunction with the bedside team at all UMMS L&D units to provide...