offer. Responsibilities Manage assigned Registered Nurse (RN) case managers, related activities and workflow to ensure effective... but not limited to: Access Authorization and pre-certification, utilization review and denial management, Care Coordination...
regarding admissions, case management, discharge planning and utilization review. Responsibilities: Review admissions... and coordinate discharge planning needs with healthcare team members. May prepare statistical analysis and utilization review...
regarding admissions, case management, discharge planning and utilization review. Responsibilities: Review admissions... and coordinate discharge planning needs with healthcare team members. May prepare statistical analysis and utilization review...
utilization review processes, including management of patient statusing processes and monitoring of medical necessity review... performance indicators for all utilization review activities. Interact with medical, nursing, and executive leadership...
Our Client, a Health Insurance company, is looking for an Utilization Review Specialist for their Baltimore, MD/ Hybrid... location. Responsibilities: Utilizing key principles of utilization management, the Utilization Review Specialist...
PURPOSE: Utilizing key principles of utilization management, the Utilization Review Specialist will perform.... Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information...
Title: Registered Nurse / LPN Duration: 12 Months+ Location: Baltimore, MD - Remote Required Experience: 5... management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for authorization...
the degree. Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state...! Job Description General Summary Under general administrative direction, the Ambulatory Nurse Manager is accountable for the delivery...
-effective utilization of available resources (human, material and financial) and ensures a high level of quality of care... actions. Maintains ongoing communication with associates to review programs, provide feedback, discuss new developments...