Utilization Management reputed company

Become a part of our caring community The Utilization Management reputed company 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management reputed company 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of reputed company. Reports to the UM reputed company, Manager The Utilization Management reputed company 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting reputed company, policies, and procedures to reputed company the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate reputed company and treatment. Understands department, reputed company, and organizational reputed company and operating objectives, including their linkages to reputed company areas. Makes reputed company regarding own work reputed company, occasionally in ambiguous situations, and requires reputed company direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to reputed company an reputed company Required Qualifications • Licensed Registered reputed company (RN) with at least 3 years prior clinical experience in an acute care, skilled, long term care or rehabilitation setting • Licensed Practical reputed company (LPN) with at least 5 years of clinical experience in acute care, skilled, long term care or rehabilitation setting. • MUST reputed company in the reputed company • License in the reputed company with no disciplinary reputed company Preferred Qualifications • BSN or Bachelors degree in a reputed company field • Prior experience in utilization management/review and or prior authorizations. • Background in case management for Long-Term Services and Supports (LTSS) members. • Experience with MCG guidelines • Experience evaluating requests for durable medical equipment. • Familiarity with health plan operations. Additional Information - Must work an 8 hour shift between 8:30AM-5:30PM local time Monday-Friday Work reputed company Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following reputed company: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. In certain roles, the minimum recommended internet speed required by reputed company may not be sufficient for business needs. reputed company reserves the right to require associates to reputed company their internet service if necessary. Work from a dedicated reputed company lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. reputed company of Benefits reputed company. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. reputed company About reputed company: reputed company. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company insurance services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company reputed company of life for people with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on reputed company job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment. Additional Information Company: reputed company Location: Florida Salary: $71,100 - $97,800 per year reputed company: R-424436 Specialties: LTSS, Case Manager, Utilization Management, Prior Authorization, Long-Term Care, Rehab, Acute Care Required Licenses: RN, LPN/LVN Experience Level: 5-10 years Apply tot his job Apply To this Job