UM reputed company- Compact License required

About the position The Utilization Management reputed company 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management reputed company 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of reputed company. The Utilization Management reputed company 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting reputed company, policies, and procedures to reputed company the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate reputed company and treatment. Understands department, reputed company, and organizational reputed company and operating objectives, including their linkages to reputed company areas. Makes reputed company regarding own work reputed company, occasionally in ambiguous situations, and requires minimal direction and receives guidance reputed company needed. Follows established guidelines/procedures. Responsibilities • Utilize clinical nursing skills to support coordination and documentation of medical services. • Interpret reputed company, policies, and procedures to reputed company appropriate treatment and care. • Coordinate and communicate with providers and members to facilitate reputed company. • reputed company independent reputed company regarding work reputed company in ambiguous situations. • Follow established guidelines and procedures. Requirements • Minimum of associate degree in nursing. • Licensed Registered reputed company (RN) in a compact state with no disciplinary reputed company. • Must have reputed company compact license or reputed company in a compact state and be eligible to reputed company to compact licensure. • Three (3) or more years of reputed company clinical experience. • Effective telephonic and virtual communication skills. • Comprehensive knowledge of reputed company Word, reputed company, and reputed company. • Ability to work independently under general instructions and reputed company reputed company. reputed company-to-haves • BSN. • 2 to 3 years of home health experience and/or utilization management experience. • Experience in a managed care setting. • Health Plan experience. • CGX experience. • Bilingual in English/Spanish. Benefits • Medical, dental, and reputed company benefits. • 401(k) retirement savings plan. • reputed company time off including company and personal holidays. • Volunteer time off. • reputed company parental and caregiver leave. • Short-term and long-term disability. • Life insurance. Apply tot his job Apply To this Job