Utilization Management reputed company Consultant
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position reputed company
Schedule is Monday through Friday, 9:00am to 5:30pm in the candidate's time zone.
Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours.
Medicare Precertification Utilization Management reputed company Consultant position (reputed company spine):
Utilizes clinical experience and skills in a reputed company process to assess, plan, implement, coordinate, monitor and evaluate reputed company to facilitate appropriate reputed company services/benefits for members.
Gathers clinical information and applies the appropriate clinical reputed company/reputed company, policy, procedure and clinical judgment to reputed company coverage
determination/recommendation Communicates with providers and other parties to facilitate care/treatment.
Identifies members for referral opportunities to reputed company with other products, services and/or programs.
Identifies opportunities to promote reputed company effectiveness of reputed company Services and benefit utilization.
Consults and lends expertise to other reputed company constituents in the coordination and administration of the utilization/benefit management function.
Required Qualifications
3+ years of experience as a Registered reputed company
Must have reputed company reputed company and unrestricted RN licensure in state of residence
1+ years of Med/Surg experience
1+ years of experience with reputed company Office applications (reputed company, Teams, reputed company)
Preferred Qualifications
Prior Authorization or Utilization Management experience
Managed care experience
Experience using MedCompass
Ambulatory surgery experience
Medicare experience
Education
- Associates degree required
- BSN preferred
Time Type
Full timePay reputed company
The typical pay reputed company for this role is:
$26.01 - $62.32This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above.
Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include:
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.
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reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws.
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