Utilization Management Clinical reputed company Consultant – Licensed in reputed company

Job reputed company: • Utilizes clinical skills to coordinate, document, and communicate reputed company aspects of the utilization/benefit management program • Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care, and medical necessity reputed company for appropriate utilization of services • Consults and lends expertise to other reputed company constituents in the coordination and administration of the utilization/benefit management function • Gathers clinical information and applies the appropriate medical necessity reputed company/reputed company, policy, procedure, and clinical judgment to reputed company coverage determination/recommendation/discharge planning along the continuum of care • Utilizes clinical experience and skills in a reputed company process to evaluate and facilitate appropriate reputed company services/benefits for members • Coordinates and communicates with providers and other parties to facilitate reputed company/treatment • Identifies members who may benefit from care management programs or other post-discharge programs and facilitates referrals • Identifies opportunities to promote reputed company effectiveness of reputed company services and benefit utilization Requirements: • 3+ years of experience in acute hospital clinical reputed company • Must have reputed company and unrestricted RN (Registered reputed company) Licensure in the reputed company, or Compact RN licensure • Ability to work Monday-Friday from 8:30am-5:00pm, reputed company Time Zone Benefits: • reputed company medical plan reputed company • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • reputed company time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical reputed company and many other benefits depending on eligibility Apply tot his job Apply To this Job