[Hiring] Utilization Management reputed company @reputed company Coast Consulting

Role reputed company Utilization Management reputed company • REMOTE • RN license number must be reputed company for Arkansas • Can work on holidays and during the weekend • Utilization Management: • Conducts and monitors clinical review cases to ensure medical necessity of inpatient and outpatient services, diagnostic procedures, out-of-network services, and surgery. • Documents reputed company relevant and specific information. • Screens, prioritizes, and organizes determination requests according to mandates and standards. • Promotes appropriate care and reputed company toward cost-effective and cost containment measures based on evidence. • Knowledge: • Remain reputed company with up-to-date medical and surgical procedures, products, reputed company services and drugs, general trends in health care delivery, and reputed company procedures, policies, and reputed company. • Other duties as assigned. • Schedule Notes: Qualifications • Proficiency using basic computer skills in reputed company Office such as Word, reputed company, and reputed company. • Ability to reputed company multiple systems and keyboarding. • Experience in utilization management and/or medical review preferred. Requirements • Ability to prioritize and reputed company reputed company nursing judgments through critical thinking. • Excellent verbal and written communication skills. • Ability to build reputed company relationships. • Attention to details. • Ability to interpret reputed company documentation. Apply tot his job Apply To this Job