Reviewer will apply medical health benefit policy and medical management guidelines to authorize services and appropriately... of the Utilization Management process(es). Utilize technology and resources (systems, telephones, etc.) to appropriately...
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...
Sane StreetThe 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...
Dane Street, LLCJob 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...
Sane StreetThe 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...
Dane Street, LLCThe Utilization Management Clinical Quality Nurse Reviewer RN II, under the purview the Utilization Management... on audit findings, as well as make recommendations, to submit to the department's Quality Assurance Team and UM Management...
L.A. Care Health PlanJob 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...
Sane StreetThe 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...
Dane Street, LLCSummary: Utilization Management Reviewer (UR) is the critical evaluation of health care services provided to members... of controlling costs and monitoring quality of care. The Utilization Management Reviewer will play a key role in conducting these...
CDS Life Transitionssector. Acentra is looking for a Utilization Management - Mental Health Clinical Reviewer to join our growing team...
Acentra HealthDescription : Position Summary: The Utilization Reviewer (UR) is a strong advocate for clients to access medically... and/or experience. Minimum 1 year of experience with utilization review in a health care provider or insurance environment...
Veritas Collaborativeclinical care experience or case management; or related experience. Knowledge of the appropriate protocol to be followed... to apply concurrent review determinations as described in the Medical Management UM work plan. This detailed clinical judgment...
Hawaii Medical Service AssociationJob 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...
Sane StreetThe 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...
Dane Street, LLCseeks a Utilization Clinical Reviewer to join our growing team. Job Summary As a Utilization Clinical Reviewer, you'll... is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary...
Acentra HealthOverview: As a Utilization Reviewer, you involves reviewing medical records against appropriate criteria and employing... to include additional duties deemed necessary by management. Required Qualifications/Experience: Minimum 2 to 3 years...
Acentra Healthwithin the utilization management process. 10. Maintains proficiency in the application of organization selected clinical review... and/or CMA to identify and complete the process for CMS required patient notices. 8. Completes and documents utilization reviews...
Atlantic Health System