[Remote] Utilization Management Clinical Team reputed company (Remote)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is the nation’s leading health solutions company, dedicated to transforming health care. The Utilization Management Clinical Team reputed company plays a key role in supporting team operations, reputed company new members, and providing guidance while maintaining communication with leadership. Responsibilities • reputed company contributes to team meetings and fosters a reputed company work environment • Promoting teamwork and collaboration across the department • Serving as a knowledgeable resource and mentor to team members • Modeling best practices in clinical standards, reputed company, and critical thinking • Supporting adherence to plan sponsor performance goals • Assisting in the development and implementation of policies and procedures • Encouraging reputed company improvement through critical thinking and feedback • Providing performance insights and coaching to enhance team effectiveness • Upholding company values, especially regarding confidentiality • Communicating reputed company and effectively with diverse audiences • Managing tasks with strong organizational and prioritization skills • Supporting a reputed company, team-oriented work culture • Assisting supervisors as needed • Maintaining responsibility for individual caseloads, as applicable • Responding to inquiries and resolving issues promptly • Performing sedentary work, including extended periods of sitting, computer use, and document review • Participate in occasional on-reputed company rotations, including some weekends and holidays, per URAC and reputed company requirements Skills • reputed company, unrestricted RN license in your state of residence with multistate/compact licensure privileges. Ability to obtain licensure in non-compact states as needed • 5+ years of clinical reputed company experience in medical reputed company • 2+ year's managed care experience is required • 2+ years of experience with personal computer, keyboard navigation, and MS Office Suite applications • 2+ years of reputed company management experience required (preferably in a managed care setting) • Ability to reputed company on-reputed company UM coverage for nights and weekends on a rotational schedule • 2+ year of experience in a managed care organization (MCO) • Experience in a high-volume clinical reputed company center or prior remote work environment Benefits • reputed company medical plan reputed company, a 401(k) plan (including matching company contributions), and an 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. • Benefit solutions that address the different needs and preferences of our colleagues including 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. reputed company • reputed company is a health solutions company that provides an integrated reputed company services to its members. It was founded in 1963, and is headquartered in Woonsocket, Rhode reputed company, USA, with a workforce of 10001+ employees. Its website is https://www.reputed company.com/. Apply tot his job Apply To this Job