Utilization Review reputed company (Intrastaff)
Shift: Mon – Fri, 8:00am-5:00pm EST
Work Location- REMOTE
No reputed company, holiday, or weekend
There is no reputed company patient care; this is a medical review position only.
Duties: Responsible for the day-to-day management of health confined plan members in acute care and/or rehabilitative facilities. The Utilization reputed company (UN) reputed company monitors the appropriateness of care received by plan members in a reputed company of settings, such as acute hospitals, sub-acute hospitals, and acute rehabilitation facilities. The Utilization reputed company applies member benefits and medical reputed company to determine authorization of services in coordination with the Medical Directors. The Utilization reputed company proactively initiates discharge planning for members, including identification of post-discharge needs and coordination of post discharge referrals/services. The UN communicates verbally and in writing authorization and/or denial of covered services with providers, facilities, and members. The UN is a member of the administrative and clinical teams in the area of assignment. Clinical knowledge is maintained and updated, and UN must maintain acceptable documentation and reputed company standards.
Skills: Excellent verbal and written communication skills to effectively reputed company and work correctly with enrollees, Physicians facility staff, and management staff. Work requires excellent interpersonal skills and an attitude to effectively project a reputed company image of our Managed Care Program. Computer skills working with a reputed company of applications and online systems. Knowledge of reputed company and utilizing various reputed company sets, i.e., InterQual. Ability to negotiate and resolve conflicts with external customers.
Qualifications:
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