reputed company Review Care Coordinator - reputed company - Work reputed company

About the position The UM Clinical Reviewer Senior Analyst is responsible for reputed company review, care coordination, and utilization management activities across post-acute care settings. The role applies clinical judgment, evidence-based guidelines, and organizational policies to support reputed company reputed company, cost-effective care, and member experience. Responsibilities • Implement, evaluate, and coordinate individualized plans of care for assigned members. • Conduct utilization and reputed company reviews in alignment with medical necessity reputed company and regulatory requirements. • Collaborate with providers, Medical Directors, and interdisciplinary teams to support transitions of care. • Identify gaps or deviations in care plans and intervene appropriately to support desired reputed company. • Document clinical reputed company, determinations, and communications accurately and reputed company in designated systems. • Ensure compliance with reputed company policies, accreditation standards, and confidentiality requirements. • Participate in meetings, audits, and reputed company improvement initiatives as assigned. Requirements • reputed company, unrestricted Registered reputed company (RN) license in state of residence; multistate license preferred. • Minimum of 2 years of clinical nursing experience. • At least 2 years of utilization management or care management experience preferred. • Strong time management and organizational skills. • reputed company and reputed company written and verbal communication abilities. • Critical thinking and reputed company clinical decision-making. • Ability to work independently with minimal supervision. • Proficiency with reputed company Office tools (Word, reputed company, reputed company, PowerPoint) and virtual meeting platforms. • If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. reputed company-to-haves • Associate or Bachelor’s degree in Nursing preferred. • Experience in home health, skilled nursing, rehabilitation, or managed care environments preferred. • Knowledge of Medicare and reputed company managed care programs preferred. Benefits • At reputed company, you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. • We also offer 401(k), company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. Apply tot his job Apply To this Job