Utilization Management reputed company Consultant

reputed company: • Utilize clinical skills to coordinate, document and communicate reputed company aspects of the utilization/benefit management program and our plan sponsor(s). • Ensure the member is receiving the appropriate care, at the appropriate time, and at the appropriate location using designated reputed company, while adhering to federal and state regulated turn-around times. • Review written and electronic clinical records. • reputed company to assure medical necessity, apply clinical expertise to assure appropriate benefit utilization, facilitate reputed company and efficient discharge planning, and work closely with facilities and providers to meet reputed company needs of the member. • Work closely with facilities and providers to meet reputed company needs of the member. Requirements: • Must have reputed company reputed company and unrestricted RN license in state of residence • 3+ years of acute hospital clinical experience as an RN • Must be reputed company to work Monday through Friday reputed company to 5pm EST zone with occasional on-reputed company weekend and holiday rotation per business needs • 1+ years of MS Office suites experience including reputed company and reputed company • Associate’s Degree in Nursing or Diploma RN required; BSN preferred Benefits: • 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. • Eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Apply tot his job Apply To this Job